The holder whose full name is Deschamps, Domenico Jose,come from Merrillville IN,hold the CSR-Physician license(NO.01022994B) which status is Expired.
| Name | Deschamps, Domenico Jose |
|---|---|
| License Number | 01022994B |
| License Type | CSR-Physician |
| License Status | Expired |
| City | Merrillville |
| State | IN |