The holder whose full name is Benifiel, Bruce Philip,come from Granger IN,hold the CSR-Dentist license(NO.12008886B) which status is Active.
| Name | Benifiel, Bruce Philip |
|---|---|
| License Number | 12008886B |
| License Type | CSR-Dentist |
| License Status | Active |
| City | Granger |
| State | IN |