The holder whose full name is Izah, Augustine Ikechukwu,come from Merrillville IN,hold the CSR-Physician license(NO.01042994B) which status is Active.
| Name | Izah, Augustine Ikechukwu |
|---|---|
| License Number | 01042994B |
| License Type | CSR-Physician |
| License Status | Active |
| City | Merrillville |
| State | IN |