The holder whose full name is Chentnik, Richard M.,come from LOGANSPORT IN,hold the CSR-Dentist license(NO.12006184B) which status is Revoked.
| Name | Chentnik, Richard M. |
|---|---|
| License Number | 12006184B |
| License Type | CSR-Dentist |
| License Status | Revoked |
| City | LOGANSPORT |
| State | IN |