The holder whose full name is Chism, Amanda B.,come from Louisville KY,hold the Medical Residency Permit license(NO.11015758A) which status is Expired.
| Name | Chism, Amanda B. |
|---|---|
| License Number | 11015758A |
| License Type | Medical Residency Permit |
| License Status | Expired |
| City | Louisville |
| State | KY |