The holder whose full name is AMENTA III, CHARLES ANTHONY,come from FLOSSMOOR IL,hold the Physician license(NO.01044189A) which status is Expired Non-Renewable.
| Name | AMENTA III, CHARLES ANTHONY |
|---|---|
| License Number | 01044189A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | FLOSSMOOR |
| State | IL |