The holder whose full name is KOOB, TIMOTHY J,come from GREENWOOD IN,hold the Dental Intern Permit license(NO.42000081A) which status is Expired.
| Name | KOOB, TIMOTHY J |
|---|---|
| License Number | 42000081A |
| License Type | Dental Intern Permit |
| License Status | Expired |
| City | GREENWOOD |
| State | IN |