The holder whose full name is Blackford, Dianne E.,come from Elwood IN,hold the Health Facility Administrator license(NO.14000267A) which status is Expired.
| Name | Blackford, Dianne E. |
|---|---|
| License Number | 14000267A |
| License Type | Health Facility Administrator |
| License Status | Expired |
| City | Elwood |
| State | IN |