The holder whose full name is Faines, Larry,come from Scottsburg IN,hold the CSR-Physician license(NO.01070916B) which status is Expired.
| Name | Faines, Larry |
|---|---|
| License Number | 01070916B |
| License Type | CSR-Physician |
| License Status | Expired |
| City | Scottsburg |
| State | IN |