The holder whose full name is Brockman, Amy E.,come from Junction City KS,hold the Dental Intern Permit license(NO.42000345A) which status is Superceded.
| Name | Brockman, Amy E. |
|---|---|
| License Number | 42000345A |
| License Type | Dental Intern Permit |
| License Status | Superceded |
| City | Junction City |
| State | KS |