The holder whose full name is LANTER, KENNETH ELWOOD,come from Madison IN,hold the CSR-Physician license(NO.01040884D) which status is Expired.
| Name | LANTER, KENNETH ELWOOD |
|---|---|
| License Number | 01040884D |
| License Type | CSR-Physician |
| License Status | Expired |
| City | Madison |
| State | IN |