The holder whose full name is LAKE, CLIFTON BLAINE,come from LOUISVILLE KY,hold the Health Facility Administrator license(NO.14004371A) which status is Active.
| Name | LAKE, CLIFTON BLAINE |
|---|---|
| License Number | 14004371A |
| License Type | Health Facility Administrator |
| License Status | Active |
| City | LOUISVILLE |
| State | KY |