The holder whose full name is Houghton, Adam Daniel,come from South Bend IN,hold the CSR-Physician license(NO.01070600B) which status is Expired.
| Name | Houghton, Adam Daniel |
|---|---|
| License Number | 01070600B |
| License Type | CSR-Physician |
| License Status | Expired |
| City | South Bend |
| State | IN |