The holder whose full name is Montgomery, Faith B.,come from South Bend IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS001366) which status is Superceded.
| Name | Montgomery, Faith B. |
|---|---|
| License Number | XS001366 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | South Bend |
| State | IN |