The holder whose full name is BEM, JIRI,come from Fayetteville NY,hold the Physician license(NO.01048761A) which status is Expired Non-Renewable.
| Name | BEM, JIRI |
|---|---|
| License Number | 01048761A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | Fayetteville |
| State | NY |