The holder whose full name is Wagner, Susan Elaine,come from Indianapolis IN,hold the Dentist - Light Parenteral Conscious Sedation license(NO.12008739A) which status is Active.
| Name | Wagner, Susan Elaine |
|---|---|
| License Number | 12008739A |
| License Type | Dentist - Light Parenteral Conscious Sedation |
| License Status | Active |
| City | Indianapolis |
| State | IN |