The holder whose full name is Backs, Alton Joseph,come from SOUTH BEND IN,hold the CSR-Physician license(NO.01016564B) which status is Expired.
| Name | Backs, Alton Joseph |
|---|---|
| License Number | 01016564B |
| License Type | CSR-Physician |
| License Status | Expired |
| City | SOUTH BEND |
| State | IN |