The holder whose full name is Blackwell, Kimberly Suzzane,come from Fortville IN,hold the CSR-Physician Assistant license(NO.10000609B) which status is Expired.
| Name | Blackwell, Kimberly Suzzane |
|---|---|
| License Number | 10000609B |
| License Type | CSR-Physician Assistant |
| License Status | Expired |
| City | Fortville |
| State | IN |