The holder whose full name is JENSEN, IMOGENE MAXINE,come from MICHIGAN CITY IN,hold the Health Facility Administrator license(NO.14003494A) which status is Expired.
| Name | JENSEN, IMOGENE MAXINE |
|---|---|
| License Number | 14003494A |
| License Type | Health Facility Administrator |
| License Status | Expired |
| City | MICHIGAN CITY |
| State | IN |