The holder whose full name is Alavanja, Branko,come from South Bend IN,hold the CSR-Dentist license(NO.12011615B) which status is Active.
| Name | Alavanja, Branko |
|---|---|
| License Number | 12011615B |
| License Type | CSR-Dentist |
| License Status | Active |
| City | South Bend |
| State | IN |