The holder whose full name is Blackburn, Christopher L.,come from Indianapolis IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS004510) which status is Expired Non-Renewable.
| Name | Blackburn, Christopher L. |
|---|---|
| License Number | XS004510 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Expired Non-Renewable |
| City | Indianapolis |
| State | IN |