The holder whose full name is SHORT, DWIGHT BRYAN,come from CRESTWOOD KY,hold the Physician license(NO.01023754A) which status is Expired Non-Renewable.
| Name | SHORT, DWIGHT BRYAN |
|---|---|
| License Number | 01023754A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | CRESTWOOD |
| State | KY |