The holder whose full name is LOPEZ, JUAN MANUEL,come from FAIRBANKS AK,hold the Physician license(NO.01034636A) which status is Expired Non-Renewable.
| Name | LOPEZ, JUAN MANUEL |
|---|---|
| License Number | 01034636A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | FAIRBANKS |
| State | AK |