The holder whose full name is Clemente, Joseph Bautista,come from Richmond IN,hold the CSR-Physician license(NO.01054059B) which status is Active.
| Name | Clemente, Joseph Bautista |
|---|---|
| License Number | 01054059B |
| License Type | CSR-Physician |
| License Status | Active |
| City | Richmond |
| State | IN |