The holder whose full name is Iczkovitz, Michael Louis,come from Fort Wayne IN,hold the Dental Anesthesia Permit - GADS license(NO.43000120A) which status is Active.
Name | Iczkovitz, Michael Louis |
---|---|
License Number | 43000120A |
License Type | Dental Anesthesia Permit - GADS |
License Status | Active |
City | Fort Wayne |
State | IN |