The holder whose full name is SMITH, LARRY EVERETT,come from BLOOMINGTON IN,hold the Physician license(NO.01031456A) which status is Expired Non-Renewable.
| Name | SMITH, LARRY EVERETT |
|---|---|
| License Number | 01031456A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | BLOOMINGTON |
| State | IN |