The holder whose full name is NOWACEK, CHARLES JAMES,come from TERRE HAUTE IN,hold the CSR-Physician license(NO.01036224B) which status is Expired.
| Name | NOWACEK, CHARLES JAMES |
|---|---|
| License Number | 01036224B |
| License Type | CSR-Physician |
| License Status | Expired |
| City | TERRE HAUTE |
| State | IN |