The holder whose full name is Fouts, Andrew Michael,come from Indianapolis IN,hold the Medical Residency Permit license(NO.11009849A) which status is Superceded.
| Name | Fouts, Andrew Michael |
|---|---|
| License Number | 11009849A |
| License Type | Medical Residency Permit |
| License Status | Superceded |
| City | Indianapolis |
| State | IN |