The holder whose full name is Bales, Bruce Gavin,come from WINCHESTER IN,hold the CSR-Dentist license(NO.12009184B) which status is Expired.
| Name | Bales, Bruce Gavin |
|---|---|
| License Number | 12009184B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | WINCHESTER |
| State | IN |