The holder whose full name is LUDVIGSEN, CARL W,come from Avon IN,hold the CSR-Physician license(NO.01051605B) which status is Expired.
| Name | LUDVIGSEN, CARL W |
|---|---|
| License Number | 01051605B |
| License Type | CSR-Physician |
| License Status | Expired |
| City | Avon |
| State | IN |