The holder whose full name is Ballentine, Erica R.,come from Auburn IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS006017) which status is Superceded.
| Name | Ballentine, Erica R. |
|---|---|
| License Number | XS006017 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | Auburn |
| State | IN |