The holder whose full name is Wilt, Jennifer L.,come from Portage IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS001633) which status is Superceded.
| Name | Wilt, Jennifer L. |
|---|---|
| License Number | XS001633 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | Portage |
| State | IN |