The holder whose full name is Pittak, Marcie J.,come from Indianapolis IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS000895) which status is Superceded.
| Name | Pittak, Marcie J. |
|---|---|
| License Number | XS000895 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | Indianapolis |
| State | IN |