The holder whose full name is Tieken, Bernice R.,come from Evansville IN,hold the Dental Radiographer license(NO.XT001646) which status is Expired.
| Name | Tieken, Bernice R. |
|---|---|
| License Number | XT001646 |
| License Type | Dental Radiographer |
| License Status | Expired |
| City | Evansville |
| State | IN |