The holder whose full name is Phillips, Larry Gordon,come from Corydon IN,hold the CSR-Dentist license(NO.12011077C) which status is Active.
| Name | Phillips, Larry Gordon |
|---|---|
| License Number | 12011077C |
| License Type | CSR-Dentist |
| License Status | Active |
| City | Corydon |
| State | IN |