The holder whose full name is Laderer, Clarence Port,come from South Bend IN,hold the Dentist license(NO.12006396A) which status is Expired.
| Name | Laderer, Clarence Port |
|---|---|
| License Number | 12006396A |
| License Type | Dentist |
| License Status | Expired |
| City | South Bend |
| State | IN |