The holder whose full name is LEWIS, CARSON M,come from INDIANAPOLIS IN,hold the Medical Residency Permit license(NO.11004325A) which status is Expired.
| Name | LEWIS, CARSON M |
|---|---|
| License Number | 11004325A |
| License Type | Medical Residency Permit |
| License Status | Expired |
| City | INDIANAPOLIS |
| State | IN |