The holder whose full name is WIEDEMAN, LARRY D,come from LAFAYETTE IN,hold the Health Facility Administrator license(NO.14003314A) which status is Expired.
| Name | WIEDEMAN, LARRY D |
|---|---|
| License Number | 14003314A |
| License Type | Health Facility Administrator |
| License Status | Expired |
| City | LAFAYETTE |
| State | IN |