The holder whose full name is Gillam, Kollette A.,come from Flora IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS002844) which status is Superceded.
| Name | Gillam, Kollette A. |
|---|---|
| License Number | XS002844 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | Flora |
| State | IN |