The holder whose full name is LIRA, ERNESTO,come from GRIFFITH IN,hold the CSR-Physician license(NO.01048664B) which status is Expired.
| Name | LIRA, ERNESTO |
|---|---|
| License Number | 01048664B |
| License Type | CSR-Physician |
| License Status | Expired |
| City | GRIFFITH |
| State | IN |