The holder whose full name is ORTIZ, EDWARD ALLAN,come from DANVILLE IL,hold the Physician license(NO.01033112A) which status is Expired Non-Renewable.
| Name | ORTIZ, EDWARD ALLAN |
|---|---|
| License Number | 01033112A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | DANVILLE |
| State | IL |