The holder whose full name is Ault, Connie L.,come from LaPorte IN,hold the Dental Radiographer license(NO.XT010895) which status is Active.
| Name | Ault, Connie L. |
|---|---|
| License Number | XT010895 |
| License Type | Dental Radiographer |
| License Status | Active |
| City | LaPorte |
| State | IN |