The holder whose full name is Clark, Heather Michelle,come from Kendallville IN,hold the CSR-Physician license(NO.01069280B) which status is Active.
| Name | Clark, Heather Michelle |
|---|---|
| License Number | 01069280B |
| License Type | CSR-Physician |
| License Status | Active |
| City | Kendallville |
| State | IN |