The holder whose full name is O SHAUGHNESSY, PHILLIP E,come from FORT WAYNE IN,hold the Dental Anesthesia Permit - Light Parenteral Conscious Sedation license(NO.43000084A) which status is Expired.
| Name | O SHAUGHNESSY, PHILLIP E |
|---|---|
| License Number | 43000084A |
| License Type | Dental Anesthesia Permit - Light Parenteral Conscious Sedation |
| License Status | Expired |
| City | FORT WAYNE |
| State | IN |