The holder whose full name is LAPUT, AMADOR JARDIEL,come from LOGANSPORT IN,hold the Physician license(NO.01041252A) which status is Expired Non-Renewable.
| Name | LAPUT, AMADOR JARDIEL |
|---|---|
| License Number | 01041252A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | LOGANSPORT |
| State | IN |