The holder whose full name is Chang, Millie Mary,come from Indianapolis IN,hold the Dental Intern Permit license(NO.42000214A) which status is Superceded.
| Name | Chang, Millie Mary |
|---|---|
| License Number | 42000214A |
| License Type | Dental Intern Permit |
| License Status | Superceded |
| City | Indianapolis |
| State | IN |