The holder whose full name is Long, Brooke Ellen,come from Daleville IN,hold the Dental Hygiene Anesthesia Permit license(NO.89000394A) which status is Active.
| Name | Long, Brooke Ellen |
|---|---|
| License Number | 89000394A |
| License Type | Dental Hygiene Anesthesia Permit |
| License Status | Active |
| City | Daleville |
| State | IN |