The holder whose full name is Bewick, Kent R.,come from Portage IN,hold the CSR-Dentist license(NO.12008296B) which status is Expired.
| Name | Bewick, Kent R. |
|---|---|
| License Number | 12008296B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | Portage |
| State | IN |