The holder whose full name is AL FAQIH, ANAN SALIM,come from FORT WAYNE IN,hold the CSR-Physician license(NO.01049719B) which status is Expired.
| Name | AL FAQIH, ANAN SALIM |
|---|---|
| License Number | 01049719B |
| License Type | CSR-Physician |
| License Status | Expired |
| City | FORT WAYNE |
| State | IN |