The holder whose full name is Johnson, Mary Irene,come from Churubusco IN,hold the Dental Hygienist license(NO.13004040A) which status is Active.
| Name | Johnson, Mary Irene |
|---|---|
| License Number | 13004040A |
| License Type | Dental Hygienist |
| License Status | Active |
| City | Churubusco |
| State | IN |