The holder whose full name is KOCH, BRENTON BERL,come from Indianapolis IN,hold the Physician license(NO.01052280A) which status is Expired Non-Renewable.
| Name | KOCH, BRENTON BERL |
|---|---|
| License Number | 01052280A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | Indianapolis |
| State | IN |