The holder whose full name is Susott, Kenton Alan,come from INDIANAPOLIS IN,hold the CSR-Dentist license(NO.12006912B) which status is Expired.
| Name | Susott, Kenton Alan |
|---|---|
| License Number | 12006912B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | INDIANAPOLIS |
| State | IN |