The holder whose full name is Shambaugh, Timothy Joseph,come from Fort Wayne IN,hold the Dental Anesthesia Permit - GADS license(NO.43000087A) which status is Active.
| Name | Shambaugh, Timothy Joseph |
|---|---|
| License Number | 43000087A |
| License Type | Dental Anesthesia Permit - GADS |
| License Status | Active |
| City | Fort Wayne |
| State | IN |