The holder whose full name is LONG JR, WALTER BRUCE,come from DOTHAN AL,hold the Physician license(NO.01018072A) which status is Expired Non-Renewable.
| Name | LONG JR, WALTER BRUCE |
|---|---|
| License Number | 01018072A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | DOTHAN |
| State | AL |