The holder whose full name is Smith, Andrew Jay,come from Indianapolis IN,hold the Medical Residency Permit license(NO.11011246A) which status is Superceded.
| Name | Smith, Andrew Jay |
|---|---|
| License Number | 11011246A |
| License Type | Medical Residency Permit |
| License Status | Superceded |
| City | Indianapolis |
| State | IN |