The holder whose full name is BOULTON, LARA ANN,come from Indianapolis IN,hold the Health Facility Administrator license(NO.14004008A) which status is Expired.
| Name | BOULTON, LARA ANN |
|---|---|
| License Number | 14004008A |
| License Type | Health Facility Administrator |
| License Status | Expired |
| City | Indianapolis |
| State | IN |