The holder whose full name is Clark, Thomas R.,come from Muncie IN,hold the Dentist - Light Parenteral Conscious Sedation license(NO.12007845A) which status is Active.
| Name | Clark, Thomas R. |
|---|---|
| License Number | 12007845A |
| License Type | Dentist - Light Parenteral Conscious Sedation |
| License Status | Active |
| City | Muncie |
| State | IN |