The holder whose full name is BERENS, EDWARD JOHN,come from HAMMOND IN,hold the Dentist license(NO.12004057A) which status is Expired.
| Name | BERENS, EDWARD JOHN |
|---|---|
| License Number | 12004057A |
| License Type | Dentist |
| License Status | Expired |
| City | HAMMOND |
| State | IN |