The holder whose full name is Fabayo, Adesola Omotayo,come from Logansport IN,hold the CSR-Physician license(NO.01049201C) which status is Active.
| Name | Fabayo, Adesola Omotayo |
|---|---|
| License Number | 01049201C |
| License Type | CSR-Physician |
| License Status | Active |
| City | Logansport |
| State | IN |