The holder whose full name is Miltenberger, Jackie L.,come from South Bend IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS001357) which status is Expired Non-Renewable.
| Name | Miltenberger, Jackie L. |
|---|---|
| License Number | XS001357 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Expired Non-Renewable |
| City | South Bend |
| State | IN |