The holder whose full name is Mekala, Bhavani Prasad,come from Fort Wayne IN,hold the CSR-Physician license(NO.01073765B) which status is Active.
| Name | Mekala, Bhavani Prasad |
|---|---|
| License Number | 01073765B |
| License Type | CSR-Physician |
| License Status | Active |
| City | Fort Wayne |
| State | IN |