The holder whose full name is Forry, Allen E,come from GRANGER IN,hold the CSR-Physician license(NO.01023873B) which status is Expired.
| Name | Forry, Allen E |
|---|---|
| License Number | 01023873B |
| License Type | CSR-Physician |
| License Status | Expired |
| City | GRANGER |
| State | IN |