The holder whose full name is Lee, Derrick Ong,come from Indianapolis IN,hold the Medical Residency Permit license(NO.11011364A) which status is Expired.
| Name | Lee, Derrick Ong |
|---|---|
| License Number | 11011364A |
| License Type | Medical Residency Permit |
| License Status | Expired |
| City | Indianapolis |
| State | IN |