The holder whose full name is Ghanem, Ammar,come from Fort Wayne IN,hold the CSR-Physician license(NO.01067395B) which status is Active.
| Name | Ghanem, Ammar |
|---|---|
| License Number | 01067395B |
| License Type | CSR-Physician |
| License Status | Active |
| City | Fort Wayne |
| State | IN |