The holder whose full name is Wibisono, Bernadeta Leegan,come from Munster IN,hold the Physician license(NO.01074257A) which status is Active.
| Name | Wibisono, Bernadeta Leegan |
|---|---|
| License Number | 01074257A |
| License Type | Physician |
| License Status | Active |
| City | Munster |
| State | IN |