The holder whose full name is POWELL, TOM DALE,come from TEMPE AZ,hold the Physician license(NO.01020848A) which status is Expired Non-Renewable.
| Name | POWELL, TOM DALE |
|---|---|
| License Number | 01020848A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | TEMPE |
| State | AZ |