The holder whose full name is MARCHANT, CLARENCE H,come from BLOOMINGTON IN,hold the CSR-Physician license(NO.01011393B) which status is Expired.
| Name | MARCHANT, CLARENCE H |
|---|---|
| License Number | 01011393B |
| License Type | CSR-Physician |
| License Status | Expired |
| City | BLOOMINGTON |
| State | IN |