The holder whose full name is Head, Timothy A,come from Avon IN,hold the Medical Residency Permit license(NO.11016015A) which status is Superceded.
| Name | Head, Timothy A |
|---|---|
| License Number | 11016015A |
| License Type | Medical Residency Permit |
| License Status | Superceded |
| City | Avon |
| State | IN |