The holder whose full name is Long, Breh E.,come from Lafayette IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS000923) which status is Superceded.
| Name | Long, Breh E. |
|---|---|
| License Number | XS000923 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | Lafayette |
| State | IN |