The holder whose full name is Phelps, George Lemoine,come from PORTLAND IN,hold the Health Facility Administrator license(NO.14003825A) which status is Expired.
| Name | Phelps, George Lemoine |
|---|---|
| License Number | 14003825A |
| License Type | Health Facility Administrator |
| License Status | Expired |
| City | PORTLAND |
| State | IN |