The holder whose full name is Martin, Larry,come from Plainfield IN,hold the Medical Residency Permit license(NO.11012750A) which status is Superceded.
| Name | Martin, Larry |
|---|---|
| License Number | 11012750A |
| License Type | Medical Residency Permit |
| License Status | Superceded |
| City | Plainfield |
| State | IN |