The holder whose full name is Ellison, John Gerald,come from Vincennes IN,hold the CSR-Dentist license(NO.12006937B) which status is Active.
| Name | Ellison, John Gerald |
|---|---|
| License Number | 12006937B |
| License Type | CSR-Dentist |
| License Status | Active |
| City | Vincennes |
| State | IN |