The holder whose full name is Thompson, Michael Edward,come from FORT WAYNE IN,hold the CSR-Dentist license(NO.12008871B) which status is Active.
| Name | Thompson, Michael Edward |
|---|---|
| License Number | 12008871B |
| License Type | CSR-Dentist |
| License Status | Active |
| City | FORT WAYNE |
| State | IN |