The holder whose full name is SMITH, MARVIN DEWITT,come from GARY IN,hold the CSR-Dentist license(NO.12005837B) which status is Expired.
| Name | SMITH, MARVIN DEWITT |
|---|---|
| License Number | 12005837B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | GARY |
| State | IN |