The holder whose full name is DEZA, JUAN CARLOS,come from NEW CITY NY,hold the Physician license(NO.01032290A) which status is Expired Non-Renewable.
| Name | DEZA, JUAN CARLOS |
|---|---|
| License Number | 01032290A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | NEW CITY |
| State | NY |