The holder whose full name is Tayui, Ebenezer Mbo,come from Hammond IN,hold the CSR-Physician license(NO.01057882B) which status is Active.
| Name | Tayui, Ebenezer Mbo |
|---|---|
| License Number | 01057882B |
| License Type | CSR-Physician |
| License Status | Active |
| City | Hammond |
| State | IN |