The holder whose full name is COONEY, CHARLES J,come from FORT WAYNE IN,hold the CSR-Physician license(NO.01012555B) which status is Expired.
| Name | COONEY, CHARLES J |
|---|---|
| License Number | 01012555B |
| License Type | CSR-Physician |
| License Status | Expired |
| City | FORT WAYNE |
| State | IN |