The holder whose full name is Fogel, Earnest James,come from SANTA CLAUS IN,hold the CSR-Physician license(NO.01018280B) which status is Expired.
| Name | Fogel, Earnest James |
|---|---|
| License Number | 01018280B |
| License Type | CSR-Physician |
| License Status | Expired |
| City | SANTA CLAUS |
| State | IN |