The holder whose full name is Bourassa, Tara J.,come from Fort Wayne IN,hold the Dental Hygiene Anesthesia Permit license(NO.89001291A) which status is Active.
Name | Bourassa, Tara J. |
---|---|
License Number | 89001291A |
License Type | Dental Hygiene Anesthesia Permit |
License Status | Active |
City | Fort Wayne |
State | IN |