The holder whose full name is Fernandes, Praveen Paul,come from Omaha NE,hold the Physician license(NO.01051171A) which status is Expired Non-Renewable.
| Name | Fernandes, Praveen Paul |
|---|---|
| License Number | 01051171A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | Omaha |
| State | NE |