The holder whose full name is Prince, Clay C.,come from Fort Wayne IN,hold the Medical Residency Permit license(NO.11010762A) which status is Superceded.
| Name | Prince, Clay C. |
|---|---|
| License Number | 11010762A |
| License Type | Medical Residency Permit |
| License Status | Superceded |
| City | Fort Wayne |
| State | IN |