The holder whose full name is Niedbalski, Brian Jacob,come from Columbus IN,hold the Medical Residency Permit license(NO.11009048A) which status is Expired.
| Name | Niedbalski, Brian Jacob |
|---|---|
| License Number | 11009048A |
| License Type | Medical Residency Permit |
| License Status | Expired |
| City | Columbus |
| State | IN |