The holder whose full name is Song, Jianming,come from Portland OR,hold the Physician license(NO.01062364A) which status is Expired Non-Renewable.
| Name | Song, Jianming |
|---|---|
| License Number | 01062364A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | Portland |
| State | OR |