The holder whose full name is BAGBY, PAUL ROBERT,come from BEDFORD IN,hold the CSR-Dentist license(NO.12004636B) which status is Expired.
| Name | BAGBY, PAUL ROBERT |
|---|---|
| License Number | 12004636B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | BEDFORD |
| State | IN |