The holder whose full name is Shank, Elaine Alice,come from Fort Wayne IN,hold the Health Facility Administrator license(NO.14005224A) which status is Active.
| Name | Shank, Elaine Alice |
|---|---|
| License Number | 14005224A |
| License Type | Health Facility Administrator |
| License Status | Active |
| City | Fort Wayne |
| State | IN |