The holder whose full name is Kiami, Bashar Edmon,come from Lafayette IN,hold the CSR-Physician license(NO.01058370B) which status is Active.
| Name | Kiami, Bashar Edmon |
|---|---|
| License Number | 01058370B |
| License Type | CSR-Physician |
| License Status | Active |
| City | Lafayette |
| State | IN |