The holder whose full name is Clark, Jacquelyn S.,come from Pittsboro IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS005818) which status is Expired Non-Renewable.
| Name | Clark, Jacquelyn S. |
|---|---|
| License Number | XS005818 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Expired Non-Renewable |
| City | Pittsboro |
| State | IN |