The holder whose full name is Lutz, Scott Ivan,come from MONTICELLO IN,hold the CSR-Dentist license(NO.12008804B) which status is Active.
| Name | Lutz, Scott Ivan |
|---|---|
| License Number | 12008804B |
| License Type | CSR-Dentist |
| License Status | Active |
| City | MONTICELLO |
| State | IN |