The holder whose full name is WEAVER, IVAN K,come from GOSHEN IN,hold the Health Facility Administrator license(NO.14000947A) which status is Expired.
| Name | WEAVER, IVAN K |
|---|---|
| License Number | 14000947A |
| License Type | Health Facility Administrator |
| License Status | Expired |
| City | GOSHEN |
| State | IN |