The holder whose full name is MONTGOMERY, BETTY JANE,come from GOSHEN IN,hold the Health Facility Administrator license(NO.14000456A) which status is Expired.
| Name | MONTGOMERY, BETTY JANE |
|---|---|
| License Number | 14000456A |
| License Type | Health Facility Administrator |
| License Status | Expired |
| City | GOSHEN |
| State | IN |