The holder whose full name is ELLIS, CHARLES ROBERT,come from VENICE FL,hold the Physician license(NO.01020431A) which status is Expired Non-Renewable.
| Name | ELLIS, CHARLES ROBERT |
|---|---|
| License Number | 01020431A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | VENICE |
| State | FL |