The holder whose full name is Henrikson, Brett Anthony,come from Lafayette IN,hold the Dental Intern Permit license(NO.42000158A) which status is Expired.
| Name | Henrikson, Brett Anthony |
|---|---|
| License Number | 42000158A |
| License Type | Dental Intern Permit |
| License Status | Expired |
| City | Lafayette |
| State | IN |