The holder whose full name is Banta, Jessica,come from Franklin IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS002966) which status is Expired Non-Renewable.
| Name | Banta, Jessica |
|---|---|
| License Number | XS002966 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Expired Non-Renewable |
| City | Franklin |
| State | IN |