The holder whose full name is Salat, Annessa J.,come from La Porte IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS005654) which status is Superceded.
| Name | Salat, Annessa J. |
|---|---|
| License Number | XS005654 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | La Porte |
| State | IN |