The holder whose full name is WAIT, JEROME HERSHAL,come from COLUMBIA CITY IN,hold the CSR-Physician license(NO.01017153B) which status is Expired.
| Name | WAIT, JEROME HERSHAL |
|---|---|
| License Number | 01017153B |
| License Type | CSR-Physician |
| License Status | Expired |
| City | COLUMBIA CITY |
| State | IN |