The holder whose full name is ENGEN, DAVID WAYNE,come from INDIANAPOLIS IN,hold the Dental Intern Permit license(NO.42000152A) which status is Expired.
| Name | ENGEN, DAVID WAYNE |
|---|---|
| License Number | 42000152A |
| License Type | Dental Intern Permit |
| License Status | Expired |
| City | INDIANAPOLIS |
| State | IN |