The holder whose full name is Michaelis, Lee Albert,come from Indianapolis IN,hold the CSR-Dentist license(NO.12008120C) which status is Active.
| Name | Michaelis, Lee Albert |
|---|---|
| License Number | 12008120C |
| License Type | CSR-Dentist |
| License Status | Active |
| City | Indianapolis |
| State | IN |