The holder whose full name is Hicks, Brooks Glenn,come from Tell City IN,hold the CSR-Physician license(NO.01058797B) which status is Expired.
| Name | Hicks, Brooks Glenn |
|---|---|
| License Number | 01058797B |
| License Type | CSR-Physician |
| License Status | Expired |
| City | Tell City |
| State | IN |