The holder whose full name is Silva, Phaelon Henry,come from Watertown NY,hold the Physician license(NO.01055555A) which status is Expired Non-Renewable.
| Name | Silva, Phaelon Henry |
|---|---|
| License Number | 01055555A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | Watertown |
| State | NY |