The holder whose full name is Pruyne, Carisa M.,come from Noblesville IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS004651) which status is Superceded.
| Name | Pruyne, Carisa M. |
|---|---|
| License Number | XS004651 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | Noblesville |
| State | IN |