The holder whose full name is Jackson, Emily R.,come from Berne IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS002804) which status is Superceded.
| Name | Jackson, Emily R. |
|---|---|
| License Number | XS002804 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | Berne |
| State | IN |