The holder whose full name is SKINNER, JOHN W,come from SOUTH BEND IN,hold the CSR-Dentist license(NO.12004658B) which status is Expired.
| Name | SKINNER, JOHN W |
|---|---|
| License Number | 12004658B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | SOUTH BEND |
| State | IN |