The holder whose full name is Isaacs, Roger Lee,come from BLOOMINGTON IN,hold the CSR-Dentist license(NO.12006608B) which status is Expired.
| Name | Isaacs, Roger Lee |
|---|---|
| License Number | 12006608B |
| License Type | CSR-Dentist |
| License Status | Expired |
| City | BLOOMINGTON |
| State | IN |