The holder whose full name is Kinaia, Ban M,come from Greenwood IN,hold the Medical Residency Permit license(NO.11013968A) which status is Superceded.
| Name | Kinaia, Ban M |
|---|---|
| License Number | 11013968A |
| License Type | Medical Residency Permit |
| License Status | Superceded |
| City | Greenwood |
| State | IN |