Pennsylvania
Department of State
LYSTRA T THEOPHILLE GRANNUM
Expanded Function Dental Assistant
License number
DF004083
Date granted
08/20/2010
Date expires
03/31/2013
Class
Expanded Function Dental Assistant
Status
Expired
Address
Tampa FL 33612
palicensing.org
ID 16558329
LAST UPDATED 2024-04-16 02:09:46 UTC
LAST UPDATED 2024-04-16 02:09:46 UTC
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