The holder whose full name is Skidmore, Charles Edward,come from BATTLE GROUND IN,hold the Physician license(NO.01021239A) which status is Revoked.
| Name | Skidmore, Charles Edward |
|---|---|
| License Number | 01021239A |
| License Type | Physician |
| License Status | Revoked |
| City | BATTLE GROUND |
| State | IN |