The holder whose full name is BALL, CASTO,come from FORT WAYNE IN,hold the Health Facility Administrator license(NO.14000086A) which status is Expired.
| Name | BALL, CASTO |
|---|---|
| License Number | 14000086A |
| License Type | Health Facility Administrator |
| License Status | Expired |
| City | FORT WAYNE |
| State | IN |