The holder whose full name is Magura, Mark David,come from VALPARAISO IN,hold the CSR-Dentist license(NO.12008922C) which status is Active.
| Name | Magura, Mark David |
|---|---|
| License Number | 12008922C |
| License Type | CSR-Dentist |
| License Status | Active |
| City | VALPARAISO |
| State | IN |