The holder whose full name is Coutinho, Russel Basil,come from West Terre Haute IN,hold the Physician license(NO.01044202A) which status is Expired Non-Renewable.
| Name | Coutinho, Russel Basil |
|---|---|
| License Number | 01044202A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | West Terre Haute |
| State | IN |