The holder whose full name is Blackburn, Megan D.,come from Carmel IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS001657) which status is Superceded.
| Name | Blackburn, Megan D. |
|---|---|
| License Number | XS001657 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | Carmel |
| State | IN |