The holder whose full name is Firestone, Lisa Beth,come from Vail AZ,hold the Physician license(NO.01054691A) which status is Expired Non-Renewable.
| Name | Firestone, Lisa Beth |
|---|---|
| License Number | 01054691A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | Vail |
| State | AZ |