The holder whose full name is CHAN, TERENCE,come from Indianapolis IN,hold the Dental Intern Permit license(NO.42000196A) which status is Expired.
| Name | CHAN, TERENCE |
|---|---|
| License Number | 42000196A |
| License Type | Dental Intern Permit |
| License Status | Expired |
| City | Indianapolis |
| State | IN |