The holder whose full name is DEJEAN, EDGAR KENNETH,come from SALEM IN,hold the Dental Anesthesia Permit - Light Parenteral Conscious Sedation license(NO.43000123A) which status is Expired.
Name | DEJEAN, EDGAR KENNETH |
---|---|
License Number | 43000123A |
License Type | Dental Anesthesia Permit - Light Parenteral Conscious Sedation |
License Status | Expired |
City | SALEM |
State | IN |