The holder whose full name is Weathers, Judith Mae,come from SULLIVAN IN,hold the Health Facility Administrator license(NO.14002603A) which status is Revoked.
| Name | Weathers, Judith Mae |
|---|---|
| License Number | 14002603A |
| License Type | Health Facility Administrator |
| License Status | Revoked |
| City | SULLIVAN |
| State | IN |