The holder whose full name is Boutwell, Holly D.,come from Mooresville IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS001141) which status is Expired Non-Renewable.
| Name | Boutwell, Holly D. |
|---|---|
| License Number | XS001141 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Expired Non-Renewable |
| City | Mooresville |
| State | IN |