The holder whose full name is Kim, Juyeon,come from Valparaiso IN,hold the CSR-Physician license(NO.01071790B) which status is Active.
| Name | Kim, Juyeon |
|---|---|
| License Number | 01071790B |
| License Type | CSR-Physician |
| License Status | Active |
| City | Valparaiso |
| State | IN |