The holder whose full name is JOHANSEN, DONALD A,come from LAKEWOOD NJ,hold the Health Facility Administrator license(NO.14002948A) which status is Expired.
| Name | JOHANSEN, DONALD A |
|---|---|
| License Number | 14002948A |
| License Type | Health Facility Administrator |
| License Status | Expired |
| City | LAKEWOOD |
| State | NJ |