The holder whose full name is Wallis, Barrett Jeffrey,come from West Lafayette IN,hold the Physician license(NO.01045716A) which status is Expired Non-Renewable.
| Name | Wallis, Barrett Jeffrey |
|---|---|
| License Number | 01045716A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | West Lafayette |
| State | IN |