The holder whose full name is Altekruse, Jack Lee,come from Newburgh IN,hold the CSR-Dentist license(NO.12006683C) which status is Expired.
| Name | Altekruse, Jack Lee |
|---|---|
| License Number | 12006683C |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | Newburgh |
| State | IN |