The holder whose full name is BRACEY III, ALTAMONT H,come from LAFAYETTE IN,hold the Physician license(NO.01025219A) which status is Expired Non-Renewable.
| Name | BRACEY III, ALTAMONT H |
|---|---|
| License Number | 01025219A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | LAFAYETTE |
| State | IN |