The holder whose full name is Hickey, Joseph Edward,come from Granger IN,hold the CSR-Dentist license(NO.12011040B) which status is Active.
| Name | Hickey, Joseph Edward |
|---|---|
| License Number | 12011040B |
| License Type | CSR-Dentist |
| License Status | Active |
| City | Granger |
| State | IN |