The holder whose full name is Rusch, Jack Albert,come from New Castle IN,hold the Dental Intern Permit license(NO.42000171A) which status is Superceded.
| Name | Rusch, Jack Albert |
|---|---|
| License Number | 42000171A |
| License Type | Dental Intern Permit |
| License Status | Superceded |
| City | New Castle |
| State | IN |