The holder whose full name is Ellis, Amanda Marie,come from Bloomington IN,hold the Dental Hygiene Anesthesia Permit license(NO.89001305A) which status is Active.
| Name | Ellis, Amanda Marie |
|---|---|
| License Number | 89001305A |
| License Type | Dental Hygiene Anesthesia Permit |
| License Status | Active |
| City | Bloomington |
| State | IN |