The holder whose full name is Johnson, Michael Alan,come from Decatur IN,hold the CSR-Dentist license(NO.12010412B) which status is Expired.
| Name | Johnson, Michael Alan |
|---|---|
| License Number | 12010412B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | Decatur |
| State | IN |