The holder whose full name is Shambaugh, Jeffrey Joseph,come from Fort Wayne IN,hold the CSR-Dentist license(NO.12010642B) which status is Active.
| Name | Shambaugh, Jeffrey Joseph |
|---|---|
| License Number | 12010642B |
| License Type | CSR-Dentist |
| License Status | Active |
| City | Fort Wayne |
| State | IN |