The holder whose full name is Padla, Dennis Peter,come from SOUTH BEND IN,hold the CSR-Physician license(NO.01049960B) which status is Expired.
| Name | Padla, Dennis Peter |
|---|---|
| License Number | 01049960B |
| License Type | CSR-Physician |
| License Status | Expired |
| City | SOUTH BEND |
| State | IN |