The holder whose full name is Newman, Dustin Scott,come from Peru IN,hold the Dental Intern Permit license(NO.42000288A) which status is Superceded.
| Name | Newman, Dustin Scott |
|---|---|
| License Number | 42000288A |
| License Type | Dental Intern Permit |
| License Status | Superceded |
| City | Peru |
| State | IN |