The holder whose full name is HENRY, IDA M.,come from OSGOOD IN,hold the Health Facility Administrator license(NO.14001471A) which status is Expired.
| Name | HENRY, IDA M. |
|---|---|
| License Number | 14001471A |
| License Type | Health Facility Administrator |
| License Status | Expired |
| City | OSGOOD |
| State | IN |