The holder whose full name is SHIELDS, CHARLES ROBERT,come from CHARLESTOWN IN,hold the CSR-Physician license(NO.01030942B) which status is Expired.
| Name | SHIELDS, CHARLES ROBERT |
|---|---|
| License Number | 01030942B |
| License Type | CSR-Physician |
| License Status | Expired |
| City | CHARLESTOWN |
| State | IN |