The holder whose full name is Wagner, Elaine C.,come from OUT OF STATE CA,hold the CSR-Dentist license(NO.12007979B) which status is Expired.
| Name | Wagner, Elaine C. |
|---|---|
| License Number | 12007979B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | OUT OF STATE |
| State | CA |