The holder whose full name is Otten, Richard F.,come from Fort Wayne IN,hold the Medical Residency Permit license(NO.11012202A) which status is Superceded.
Name | Otten, Richard F. |
---|---|
License Number | 11012202A |
License Type | Medical Residency Permit |
License Status | Superceded |
City | Fort Wayne |
State | IN |