The holder whose full name is Collins, Lucille Elaine,come from Brazil IN,hold the Health Facility Administrator license(NO.14003029A) which status is Inactive.
| Name | Collins, Lucille Elaine |
|---|---|
| License Number | 14003029A |
| License Type | Health Facility Administrator |
| License Status | Inactive |
| City | Brazil |
| State | IN |