The holder whose full name is AMAYA, CARLOS ERNESTO,come from SHELBYVILLE IN,hold the CSR-Physician license(NO.01021607C) which status is Suspended.
Name | AMAYA, CARLOS ERNESTO |
---|---|
License Number | 01021607C |
License Type | CSR-Physician |
License Status | Suspended |
City | SHELBYVILLE |
State | IN |