The holder whose full name is HENDERSON JR, JERRY H,come from EAST CHICAGO IN,hold the Dentist license(NO.12004782A) which status is Expired.
| Name | HENDERSON JR, JERRY H |
|---|---|
| License Number | 12004782A |
| License Type | Dentist |
| License Status | Expired |
| City | EAST CHICAGO |
| State | IN |