The holder whose full name is JACKOWIAK, JEFFREY PAUL,come from SOUTH BEND IN,hold the Health Facility Administrator license(NO.14002619A) which status is Expired.
| Name | JACKOWIAK, JEFFREY PAUL |
|---|---|
| License Number | 14002619A |
| License Type | Health Facility Administrator |
| License Status | Expired |
| City | SOUTH BEND |
| State | IN |