The holder whose full name is Blackburn, James William,come from Evansville IN,hold the CSR-Dentist license(NO.12010139B) which status is Active.
| Name | Blackburn, James William |
|---|---|
| License Number | 12010139B |
| License Type | CSR-Dentist |
| License Status | Active |
| City | Evansville |
| State | IN |