The holder whose full name is Gandara, Manuel Jesse,come from East Chicago IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS003587) which status is Superceded.
| Name | Gandara, Manuel Jesse |
|---|---|
| License Number | XS003587 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | East Chicago |
| State | IN |