The holder whose full name is Russell, Kellie J.,come from New Whiteland IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS001055) which status is Superceded.
| Name | Russell, Kellie J. |
|---|---|
| License Number | XS001055 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | New Whiteland |
| State | IN |