The holder whose full name is Baskevice, Jacqueline Ann,come from Michigan City IN,hold the Dental Hygienist license(NO.13002246A) which status is Expired.
| Name | Baskevice, Jacqueline Ann |
|---|---|
| License Number | 13002246A |
| License Type | Dental Hygienist |
| License Status | Expired |
| City | Michigan City |
| State | IN |