The holder whose full name is Benedict, Brian Walter,come from Fishers IN,hold the Dental Intern Permit license(NO.42000192A) which status is Superceded.
| Name | Benedict, Brian Walter |
|---|---|
| License Number | 42000192A |
| License Type | Dental Intern Permit |
| License Status | Superceded |
| City | Fishers |
| State | IN |