The holder whose full name is Heeter, Mary E.,come from South Bend IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS003379) which status is Superceded.
| Name | Heeter, Mary E. |
|---|---|
| License Number | XS003379 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | South Bend |
| State | IN |