The holder whose full name is NELSON, ALBERT BURLESON,come from LAGRANGE IN,hold the CSR-Dentist license(NO.12004305B) which status is Expired.
| Name | NELSON, ALBERT BURLESON |
|---|---|
| License Number | 12004305B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | LAGRANGE |
| State | IN |