The holder whose full name is ANDERSON, LARRY EDWARD,come from WABASH IN,hold the Physician Assistant license(NO.10000051A) which status is Expired.
| Name | ANDERSON, LARRY EDWARD |
|---|---|
| License Number | 10000051A |
| License Type | Physician Assistant |
| License Status | Expired |
| City | WABASH |
| State | IN |