The holder whose full name is ORTIZ, JUAN FERNANDO,come from GREENSBURG IN,hold the Physician license(NO.01023155A) which status is Expired Non-Renewable.
| Name | ORTIZ, JUAN FERNANDO |
|---|---|
| License Number | 01023155A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | GREENSBURG |
| State | IN |