The holder whose full name is Russell, Amy N.,come from Bremen IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS002118) which status is Superceded.
| Name | Russell, Amy N. |
|---|---|
| License Number | XS002118 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | Bremen |
| State | IN |