The holder whose full name is HEIDENREICH, FREDRICK W,come from BLOOMFIELD IN,hold the Dentist license(NO.12004191A) which status is Expired.
| Name | HEIDENREICH, FREDRICK W |
|---|---|
| License Number | 12004191A |
| License Type | Dentist |
| License Status | Expired |
| City | BLOOMFIELD |
| State | IN |