The holder whose full name is Douglas, Phillip R.,come from Greencastle IN,hold the CSR-Dentist license(NO.12011180B) which status is Expired.
| Name | Douglas, Phillip R. |
|---|---|
| License Number | 12011180B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | Greencastle |
| State | IN |