The holder whose full name is Malkowski, Frederick Stanley,come from Lafayette IN,hold the CSR-Dentist license(NO.12006964I) which status is Expired.
| Name | Malkowski, Frederick Stanley |
|---|---|
| License Number | 12006964I |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | Lafayette |
| State | IN |