The holder whose full name is Iczkovitz, Michael Louis,come from Columbia City IN,hold the CSR-Dentist license(NO.12008664C) which status is Active.
| Name | Iczkovitz, Michael Louis |
|---|---|
| License Number | 12008664C |
| License Type | CSR-Dentist |
| License Status | Active |
| City | Columbia City |
| State | IN |