The holder whose full name is Montgomery, Michael D.,come from Indianapolis IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS002180) which status is Superceded.
| Name | Montgomery, Michael D. |
|---|---|
| License Number | XS002180 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | Indianapolis |
| State | IN |