The holder whose full name is BAIRES, ENRIQUE P,come from Fort Wayne IN,hold the Physician license(NO.01054522A) which status is Expired Non-Renewable.
| Name | BAIRES, ENRIQUE P |
|---|---|
| License Number | 01054522A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | Fort Wayne |
| State | IN |