The holder whose full name is WALLACE, KIMBERLY JEAN,come from ARIZONA CITY AZ,hold the Health Facility Administrator license(NO.14003570A) which status is Expired.
| Name | WALLACE, KIMBERLY JEAN |
|---|---|
| License Number | 14003570A |
| License Type | Health Facility Administrator |
| License Status | Expired |
| City | ARIZONA CITY |
| State | AZ |