The holder whose full name is TATUM JR, CLIFTON M,come from GOSHEN KY,hold the Physician license(NO.01035573A) which status is Expired Non-Renewable.
| Name | TATUM JR, CLIFTON M |
|---|---|
| License Number | 01035573A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | GOSHEN |
| State | KY |