The holder whose full name is Staples, Ashley A.,come from Newburgh IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS005136) which status is Superceded.
| Name | Staples, Ashley A. |
|---|---|
| License Number | XS005136 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | Newburgh |
| State | IN |