The holder whose full name is WELLEMEYER, MARK LAWRENCE,come from INDIANAPOLIS IN,hold the Physician license(NO.01040625A) which status is Expired Non-Renewable.
| Name | WELLEMEYER, MARK LAWRENCE |
|---|---|
| License Number | 01040625A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | INDIANAPOLIS |
| State | IN |