The holder whose full name is Phillippo, Marisol M.,come from West Lafayette IN,hold the Radiology Student Permit - Dental Radiography license(NO.XS000906) which status is Superceded.
| Name | Phillippo, Marisol M. |
|---|---|
| License Number | XS000906 |
| License Type | Radiology Student Permit - Dental Radiography |
| License Status | Superceded |
| City | West Lafayette |
| State | IN |