The holder whose full name is Tan, John Uy,come from WINCHESTER IN,hold the CSR-Physician license(NO.01042239C) which status is Expired.
| Name | Tan, John Uy |
|---|---|
| License Number | 01042239C |
| License Type | CSR-Physician |
| License Status | Expired |
| City | WINCHESTER |
| State | IN |