The holder whose full name is KONTRICK, AMY V,come from MICHIGAN CITY IN,hold the CSR-Physician license(NO.01046951B) which status is Expired.
| Name | KONTRICK, AMY V |
|---|---|
| License Number | 01046951B |
| License Type | CSR-Physician |
| License Status | Expired |
| City | MICHIGAN CITY |
| State | IN |