The holder whose full name is Blickendorf, Carl William,come from Fort Wayne IN,hold the Dentist license(NO.12006284A) which status is Expired.
| Name | Blickendorf, Carl William |
|---|---|
| License Number | 12006284A |
| License Type | Dentist |
| License Status | Expired |
| City | Fort Wayne |
| State | IN |