The holder whose full name is Evans, Booker Theodore,come from Fairbanks AK,hold the Physician license(NO.01049422A) which status is Expired Non-Renewable.
| Name | Evans, Booker Theodore |
|---|---|
| License Number | 01049422A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | Fairbanks |
| State | AK |