The holder whose full name is Summerlin, Jack Donald,come from Indianapolis IN,hold the CSR-Dentist license(NO.12011175B) which status is Expired.
| Name | Summerlin, Jack Donald |
|---|---|
| License Number | 12011175B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | Indianapolis |
| State | IN |