The holder whose full name is Lopez, Maricela,come from Monticello IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS004781) which status is Superceded.
| Name | Lopez, Maricela |
|---|---|
| License Number | XS004781 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | Monticello |
| State | IN |