The holder whose full name is Hertig, Adam Richard,come from Fort Wayne IN,hold the CSR-Dentist license(NO.12011943B) which status is Active.
| Name | Hertig, Adam Richard |
|---|---|
| License Number | 12011943B |
| License Type | CSR-Dentist |
| License Status | Active |
| City | Fort Wayne |
| State | IN |