The holder whose full name is GUCKY, JAY BERNARD,come from SOUTH BEND IN,hold the Dental Intern Permit license(NO.42000150A) which status is Expired.
| Name | GUCKY, JAY BERNARD |
|---|---|
| License Number | 42000150A |
| License Type | Dental Intern Permit |
| License Status | Expired |
| City | SOUTH BEND |
| State | IN |