The holder whose full name is Long, Brooke Ellen,come from Daleville IN,hold the Dental Radiographer license(NO.XT011064) which status is Expired.
| Name | Long, Brooke Ellen |
|---|---|
| License Number | XT011064 |
| License Type | Dental Radiographer |
| License Status | Expired |
| City | Daleville |
| State | IN |