The holder whose full name is DEJEAN, EDGAR KENNETH,come from SALEM IN,hold the Dentist - Light Parenteral Conscious Sedation license(NO.12004509A) which status is Expired.
| Name | DEJEAN, EDGAR KENNETH |
|---|---|
| License Number | 12004509A |
| License Type | Dentist - Light Parenteral Conscious Sedation |
| License Status | Expired |
| City | SALEM |
| State | IN |