The holder whose full name is Lane, Ashley T.,come from Gary IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS003167) which status is Expired Non-Renewable.
| Name | Lane, Ashley T. |
|---|---|
| License Number | XS003167 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Expired Non-Renewable |
| City | Gary |
| State | IN |