The holder whose full name is DeCeault, Leslie Renee,come from Crown Point IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS001406) which status is Superceded.
| Name | DeCeault, Leslie Renee |
|---|---|
| License Number | XS001406 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | Crown Point |
| State | IN |