The holder whose full name is Kozlowski, Alyssa,come from Fort Wayne IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS005172) which status is Superceded.
| Name | Kozlowski, Alyssa |
|---|---|
| License Number | XS005172 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | Fort Wayne |
| State | IN |