The holder whose full name is KULLBOM, JAMES BYRON,come from RAPID CITY SD,hold the Physician license(NO.01044793A) which status is Expired Non-Renewable.
Name | KULLBOM, JAMES BYRON |
---|---|
License Number | 01044793A |
License Type | Physician |
License Status | Expired Non-Renewable |
City | RAPID CITY |
State | SD |