The holder whose full name is Macias, Faviola,come from Goshen IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS005659) which status is Superceded.
| Name | Macias, Faviola |
|---|---|
| License Number | XS005659 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | Goshen |
| State | IN |