The holder whose full name is Beaty, Michael Clark,come from DANVILLE IN,hold the CSR-Dentist license(NO.12009222B) which status is Active.
| Name | Beaty, Michael Clark |
|---|---|
| License Number | 12009222B |
| License Type | CSR-Dentist |
| License Status | Active |
| City | DANVILLE |
| State | IN |