The holder whose full name is Fryar, Gene Marion,come from Michigan City IN,hold the CSR-Dentist license(NO.12005400B) which status is Expired.
| Name | Fryar, Gene Marion |
|---|---|
| License Number | 12005400B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | Michigan City |
| State | IN |