The holder whose full name is MAMINTA, AUDREY J,come from Indianapolis IN,hold the CSR-Physician license(NO.01045698B) which status is Active.
| Name | MAMINTA, AUDREY J |
|---|---|
| License Number | 01045698B |
| License Type | CSR-Physician |
| License Status | Active |
| City | Indianapolis |
| State | IN |