The holder whose full name is Wagoner, Brandy J.,come from Demotte IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS002747) which status is Superceded.
| Name | Wagoner, Brandy J. |
|---|---|
| License Number | XS002747 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | Demotte |
| State | IN |