The holder whose full name is Misecko, Nicholas,come from Lafayette IN,hold the CSR-Dentist license(NO.12005141B) which status is Expired.
| Name | Misecko, Nicholas |
|---|---|
| License Number | 12005141B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | Lafayette |
| State | IN |