The holder whose full name is Clark, Thomas R.,come from Muncie IN,hold the Dental Anesthesia Permit - Light Parenteral Conscious Sedation license(NO.43000073A) which status is Expired.
| Name | Clark, Thomas R. |
|---|---|
| License Number | 43000073A |
| License Type | Dental Anesthesia Permit - Light Parenteral Conscious Sedation |
| License Status | Expired |
| City | Muncie |
| State | IN |