The holder whose full name is Petre, Lisa M.,come from Valparaiso IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS001634) which status is Superceded.
| Name | Petre, Lisa M. |
|---|---|
| License Number | XS001634 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | Valparaiso |
| State | IN |