The holder whose full name is Johnston, Richard M.,come from FORT WAYNE IN,hold the Physician license(NO.01014638A) which status is Expired Non-Renewable.
| Name | Johnston, Richard M. |
|---|---|
| License Number | 01014638A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | FORT WAYNE |
| State | IN |