The holder whose full name is Lynde, Grant Charles,come from Tacoma WA,hold the Physician license(NO.01051415A) which status is Expired Non-Renewable.
| Name | Lynde, Grant Charles |
|---|---|
| License Number | 01051415A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | Tacoma |
| State | WA |