The holder whose full name is LICZNERSKI, ADAM BOGDAN,come from WATERTOWN NY,hold the Physician license(NO.01042594A) which status is Expired Non-Renewable.
| Name | LICZNERSKI, ADAM BOGDAN |
|---|---|
| License Number | 01042594A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | WATERTOWN |
| State | NY |