The holder whose full name is Rucker, Willie James,come from Olympia Fields IL,hold the Dental Anesthesia Permit - Light Parenteral Conscious Sedation license(NO.43000363A) which status is Expired.
| Name | Rucker, Willie James |
|---|---|
| License Number | 43000363A |
| License Type | Dental Anesthesia Permit - Light Parenteral Conscious Sedation |
| License Status | Expired |
| City | Olympia Fields |
| State | IL |