The holder whose full name is Heneisen, Amy Lynn,come from Indianapolis IN,hold the Medical Residency Permit license(NO.11008510A) which status is Expired.
| Name | Heneisen, Amy Lynn |
|---|---|
| License Number | 11008510A |
| License Type | Medical Residency Permit |
| License Status | Expired |
| City | Indianapolis |
| State | IN |