The holder whose full name is HALLECK, HAROLD JEROME,come from WINAMAC IN,hold the Physician license(NO.01011816A) which status is Expired Non-Renewable.
| Name | HALLECK, HAROLD JEROME |
|---|---|
| License Number | 01011816A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | WINAMAC |
| State | IN |