The holder whose full name is Ortiz, Kenneth John,come from Chesapeake VA,hold the Physician license(NO.01047288A) which status is Inactive/Expired.
| Name | Ortiz, Kenneth John |
|---|---|
| License Number | 01047288A |
| License Type | Physician |
| License Status | Inactive/Expired |
| City | Chesapeake |
| State | VA |