The holder whose full name is Thai, Divya,come from Rockville Centre NY,hold the Physician license(NO.01047675A) which status is Expired Non-Renewable.
| Name | Thai, Divya |
|---|---|
| License Number | 01047675A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | Rockville Centre |
| State | NY |