The holder whose full name is Granados Ortega, Berta Lisbeth,come from Elkhart IN,hold the CSR-Physician license(NO.01067659B) which status is Expired.
| Name | Granados Ortega, Berta Lisbeth |
|---|---|
| License Number | 01067659B |
| License Type | CSR-Physician |
| License Status | Expired |
| City | Elkhart |
| State | IN |