The holder whose full name is QUACKENBUSH, BRETT MICHAEL,come from INDIANAPOLIS IN,hold the Dental Intern Permit license(NO.42000140A) which status is Expired.
| Name | QUACKENBUSH, BRETT MICHAEL |
|---|---|
| License Number | 42000140A |
| License Type | Dental Intern Permit |
| License Status | Expired |
| City | INDIANAPOLIS |
| State | IN |