The holder whose full name is Vander Velde, Cornelius Diederick,come from Louisville KY,hold the Health Facility Administrator license(NO.14004728A) which status is Active.
| Name | Vander Velde, Cornelius Diederick |
|---|---|
| License Number | 14004728A |
| License Type | Health Facility Administrator |
| License Status | Active |
| City | Louisville |
| State | KY |