The holder whose full name is Wallace, David Charles,come from Elkhart IN,hold the CSR-Osteopathic Physician license(NO.02003285B) which status is Expired.
| Name | Wallace, David Charles |
|---|---|
| License Number | 02003285B |
| License Type | CSR-Osteopathic Physician |
| License Status | Expired |
| City | Elkhart |
| State | IN |