The holder whose full name is Fifer, Theodore D,come from Effingham IL,hold the Physician license(NO.01049294A) which status is Expired Non-Renewable.
| Name | Fifer, Theodore D |
|---|---|
| License Number | 01049294A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | Effingham |
| State | IL |