The holder whose full name is NAMTZE, CHAN,come from SOUTH BEND IN,hold the CSR-Physician license(NO.01034888B) which status is Expired.
| Name | NAMTZE, CHAN |
|---|---|
| License Number | 01034888B |
| License Type | CSR-Physician |
| License Status | Expired |
| City | SOUTH BEND |
| State | IN |