The holder whose full name is Martell, Michael Robert,come from CEDAR LAKE IN,hold the CSR-Dentist license(NO.12008924B) which status is Active.
| Name | Martell, Michael Robert |
|---|---|
| License Number | 12008924B |
| License Type | CSR-Dentist |
| License Status | Active |
| City | CEDAR LAKE |
| State | IN |