The holder whose full name is DAVIS, LESLIE IVAN,come from ZIONSVILLE IN,hold the CSR-Dentist license(NO.12008306B) which status is Expired.
| Name | DAVIS, LESLIE IVAN |
|---|---|
| License Number | 12008306B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | ZIONSVILLE |
| State | IN |