The holder whose full name is Porayette, Prashanth,come from Whitestown IN,hold the Medical Residency Permit license(NO.11014756A) which status is Superceded.
| Name | Porayette, Prashanth |
|---|---|
| License Number | 11014756A |
| License Type | Medical Residency Permit |
| License Status | Superceded |
| City | Whitestown |
| State | IN |