The holder whose full name is Fultz, Donna J.,come from Columbus IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS003225) which status is Superceded.
| Name | Fultz, Donna J. |
|---|---|
| License Number | XS003225 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | Columbus |
| State | IN |