The holder whose full name is GORDON, OTIS T,come from Carmel IN,hold the Physician license(NO.01053788A) which status is Expired Non-Renewable.
| Name | GORDON, OTIS T |
|---|---|
| License Number | 01053788A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | Carmel |
| State | IN |