The holder whose full name is Baines, Colleen Ann,come from Lafayette IN,hold the Dental Anesthesia Permit - Light Parenteral Conscious Sedation license(NO.43000356A) which status is Active.
| Name | Baines, Colleen Ann |
|---|---|
| License Number | 43000356A |
| License Type | Dental Anesthesia Permit - Light Parenteral Conscious Sedation |
| License Status | Active |
| City | Lafayette |
| State | IN |