The holder whose full name is Smith, Kevin C,come from La Porte IN,hold the Physician Assistant - Prescriptive Authority license(NO.10000208A) which status is Active.
| Name | Smith, Kevin C |
|---|---|
| License Number | 10000208A |
| License Type | Physician Assistant - Prescriptive Authority |
| License Status | Active |
| City | La Porte |
| State | IN |