The holder whose full name is Mirza, Aijaz Mohammed,come from WABASH IN,hold the CSR-Physician license(NO.01040888B) which status is Expired.
| Name | Mirza, Aijaz Mohammed |
|---|---|
| License Number | 01040888B |
| License Type | CSR-Physician |
| License Status | Expired |
| City | WABASH |
| State | IN |