The holder whose full name is Bormann, Thomas Joseph,come from Michigan City IN,hold the CSR-Dentist license(NO.12009455B) which status is Active.
| Name | Bormann, Thomas Joseph |
|---|---|
| License Number | 12009455B |
| License Type | CSR-Dentist |
| License Status | Active |
| City | Michigan City |
| State | IN |