The holder whose full name is Unger-Moder, Jill Anne,come from West Lafayette IN,hold the Health Facility Administrator license(NO.14003070A) which status is Suspended.
| Name | Unger-Moder, Jill Anne |
|---|---|
| License Number | 14003070A |
| License Type | Health Facility Administrator |
| License Status | Suspended |
| City | West Lafayette |
| State | IN |