The holder whose full name is Holtz, Fredrick Anthony,come from Elkhart IN,hold the CSR-Dentist license(NO.12005778B) which status is Expired.
| Name | Holtz, Fredrick Anthony |
|---|---|
| License Number | 12005778B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | Elkhart |
| State | IN |