The holder whose full name is Coats, Charles Leroy,come from Fort Wayne IN,hold the CSR-Physician license(NO.01053073B) which status is Active.
| Name | Coats, Charles Leroy |
|---|---|
| License Number | 01053073B |
| License Type | CSR-Physician |
| License Status | Active |
| City | Fort Wayne |
| State | IN |