The holder whose full name is Ison, Thomas Glenn,come from Louisville KY,hold the Dental Intern Permit license(NO.42000066A) which status is Superceded.
| Name | Ison, Thomas Glenn |
|---|---|
| License Number | 42000066A |
| License Type | Dental Intern Permit |
| License Status | Superceded |
| City | Louisville |
| State | KY |