The holder whose full name is PORTNEY, FRED R,come from MUNSTER IN,hold the Health Facility Administrator license(NO.14000707A) which status is Expired.
| Name | PORTNEY, FRED R |
|---|---|
| License Number | 14000707A |
| License Type | Health Facility Administrator |
| License Status | Expired |
| City | MUNSTER |
| State | IN |