The holder whose full name is Hertz, Bruce Michael,come from Niles IL,hold the Event Physician license(NO.PH40700005) which status is Expired Non-Renewable.
| Name | Hertz, Bruce Michael |
|---|---|
| License Number | PH40700005 |
| License Type | Event Physician |
| License Status | Expired Non-Renewable |
| City | Niles |
| State | IL |