The holder whose full name is Klise, Terry R.,come from Missoula MT,hold the Dentist license(NO.12009360A) which status is Inactive/Expired.
| Name | Klise, Terry R. |
|---|---|
| License Number | 12009360A |
| License Type | Dentist |
| License Status | Inactive/Expired |
| City | Missoula |
| State | MT |