The holder whose full name is Burgeson, Mary Lantz,come from Huntingburg IN,hold the Physician license(NO.01028935A) which status is Active.
| Name | Burgeson, Mary Lantz |
|---|---|
| License Number | 01028935A |
| License Type | Physician |
| License Status | Active |
| City | Huntingburg |
| State | IN |