The holder whose full name is VITUG, FAUSTO REYES,come from MARION IN,hold the Physician license(NO.01023058A) which status is Expired Non-Renewable.
| Name | VITUG, FAUSTO REYES |
|---|---|
| License Number | 01023058A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | MARION |
| State | IN |