The holder whose full name is NAMTZE, CHAN,come from SOUTH BEND IN,hold the Physician license(NO.01034888A) which status is Expired Non-Renewable.
Name | NAMTZE, CHAN |
---|---|
License Number | 01034888A |
License Type | Physician |
License Status | Expired Non-Renewable |
City | SOUTH BEND |
State | IN |