The holder whose full name is Slade, Dirk Lance,come from Evans GA,hold the Physician license(NO.01055126A) which status is Expired Non-Renewable.
| Name | Slade, Dirk Lance |
|---|---|
| License Number | 01055126A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | Evans |
| State | GA |