The holder whose full name is TANKSLEY, MICHAEL WAYNE,come from FORT WAYNE IN,hold the Physician license(NO.01041227A) which status is Expired Non-Renewable.
| Name | TANKSLEY, MICHAEL WAYNE |
|---|---|
| License Number | 01041227A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | FORT WAYNE |
| State | IN |