The holder whose full name is Pothiawala, Bashir,come from Lombard IL,hold the Physicist - Health license(NO.XP002326) which status is Active.
| Name | Pothiawala, Bashir |
|---|---|
| License Number | XP002326 |
| License Type | Physicist - Health |
| License Status | Active |
| City | Lombard |
| State | IL |