The holder whose full name is Bousum, Amanda M.,come from Frankfort IN,hold the Dental Radiographer license(NO.XT017581) which status is Active.
| Name | Bousum, Amanda M. |
|---|---|
| License Number | XT017581 |
| License Type | Dental Radiographer |
| License Status | Active |
| City | Frankfort |
| State | IN |