The holder whose full name is ELLIS, DAVID LEE,come from WABASH IN,hold the Physician license(NO.01021805A) which status is Expired Non-Renewable.
| Name | ELLIS, DAVID LEE |
|---|---|
| License Number | 01021805A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | WABASH |
| State | IN |