The holder whose full name is PENTZIEN JR, DWIGHT FREDERICK,come from CHARLESTON IL,hold the Medical Residency Permit license(NO.11006720A) which status is Expired.
| Name | PENTZIEN JR, DWIGHT FREDERICK |
|---|---|
| License Number | 11006720A |
| License Type | Medical Residency Permit |
| License Status | Expired |
| City | CHARLESTON |
| State | IL |