The holder whose full name is TIETZER JR, HERBERT O,come from MICHIGAN CITY IN,hold the Dentist license(NO.12005510A) which status is Expired.
| Name | TIETZER JR, HERBERT O |
|---|---|
| License Number | 12005510A |
| License Type | Dentist |
| License Status | Expired |
| City | MICHIGAN CITY |
| State | IN |