The holder whose full name is BACALA, JESUS C,come from SCOTTSBURG IN,hold the Physician license(NO.01021800A) which status is Expired Non-Renewable.
| Name | BACALA, JESUS C |
|---|---|
| License Number | 01021800A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | SCOTTSBURG |
| State | IN |