The holder whose full name is WALLENDER, GEORGE THOMAS,come from FORT WAYNE IN,hold the Physician license(NO.01042163A) which status is Expired Non-Renewable.
Name | WALLENDER, GEORGE THOMAS |
---|---|
License Number | 01042163A |
License Type | Physician |
License Status | Expired Non-Renewable |
City | FORT WAYNE |
State | IN |