The holder whose full name is Balog, Carolyn M.,come from South Bend IN,hold the Optometrist license(NO.18001983A) which status is Expired.
| Name | Balog, Carolyn M. |
|---|---|
| License Number | 18001983A |
| License Type | Optometrist |
| License Status | Expired |
| City | South Bend |
| State | IN |