The holder whose full name is Lewis, Berry Everett,come from Vincennes IN,hold the CSR-Physician license(NO.01060895C) which status is Active.
| Name | Lewis, Berry Everett |
|---|---|
| License Number | 01060895C |
| License Type | CSR-Physician |
| License Status | Active |
| City | Vincennes |
| State | IN |