The holder whose full name is Frey, Timothy James,come from Fort Wayne IN,hold the CSR-Dentist license(NO.12009756D) which status is Active.
| Name | Frey, Timothy James |
|---|---|
| License Number | 12009756D |
| License Type | CSR-Dentist |
| License Status | Active |
| City | Fort Wayne |
| State | IN |