The holder whose full name is Mekonnen, Asefa Jajaw,come from Dyer IN,hold the CSR-Physician license(NO.01056205B) which status is Expired.
| Name | Mekonnen, Asefa Jajaw |
|---|---|
| License Number | 01056205B |
| License Type | CSR-Physician |
| License Status | Expired |
| City | Dyer |
| State | IN |