The holder whose full name is FOSBRINK, EPHRAIM L,come from SYRACUSE IN,hold the CSR-Physician license(NO.01013573B) which status is Expired.
| Name | FOSBRINK, EPHRAIM L |
|---|---|
| License Number | 01013573B |
| License Type | CSR-Physician |
| License Status | Expired |
| City | SYRACUSE |
| State | IN |