The holder whose full name is Domingo, Alfredo C,come from COLUMBIA CITY IN,hold the CSR-Physician license(NO.01030645B) which status is Active.
| Name | Domingo, Alfredo C |
|---|---|
| License Number | 01030645B |
| License Type | CSR-Physician |
| License Status | Active |
| City | COLUMBIA CITY |
| State | IN |