The holder whose full name is Henry, Arnold Fauntleroy,come from Indianapolis IN,hold the CSR-Physician license(NO.01074230B) which status is Active.
| Name | Henry, Arnold Fauntleroy |
|---|---|
| License Number | 01074230B |
| License Type | CSR-Physician |
| License Status | Active |
| City | Indianapolis |
| State | IN |