The holder whose full name is WANNER, LOREN JAMES,come from BLUFFTON IN,hold the Physician license(NO.01024010A) which status is Active.
| Name | WANNER, LOREN JAMES |
|---|---|
| License Number | 01024010A |
| License Type | Physician |
| License Status | Active |
| City | BLUFFTON |
| State | IN |