The holder whose full name is LAKER, GENE CARROLL,come from FORT WAYNE IN,hold the Physician license(NO.01018457A) which status is Expired Non-Renewable.
Name | LAKER, GENE CARROLL |
---|---|
License Number | 01018457A |
License Type | Physician |
License Status | Expired Non-Renewable |
City | FORT WAYNE |
State | IN |