The holder whose full name is Chy Koa, Leticia K,come from Griffith IN,hold the CSR-Physician license(NO.01024246B) which status is Suspended.
| Name | Chy Koa, Leticia K |
|---|---|
| License Number | 01024246B |
| License Type | CSR-Physician |
| License Status | Suspended |
| City | Griffith |
| State | IN |