The holder whose full name is Pong, Henry King-Fai,come from LAKE STATION IN,hold the CSR-Dentist license(NO.12008020B) which status is Active.
| Name | Pong, Henry King-Fai |
|---|---|
| License Number | 12008020B |
| License Type | CSR-Dentist |
| License Status | Active |
| City | LAKE STATION |
| State | IN |