The holder whose full name is Puram, Ajith Kumar,come from Goshen IN,hold the CSR-Physician license(NO.01070965B) which status is Active.
| Name | Puram, Ajith Kumar |
|---|---|
| License Number | 01070965B |
| License Type | CSR-Physician |
| License Status | Active |
| City | Goshen |
| State | IN |