The holder whose full name is Smith, Amy M.,come from Russiaville IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS003504) which status is Superceded.
| Name | Smith, Amy M. |
|---|---|
| License Number | XS003504 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | Russiaville |
| State | IN |