The holder whose full name is Lodge, Monique S.,come from Indianapolis IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS005396) which status is Expired Non-Renewable.
| Name | Lodge, Monique S. |
|---|---|
| License Number | XS005396 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Expired Non-Renewable |
| City | Indianapolis |
| State | IN |