The holder whose full name is SURFACE, MARY J,come from WINGATE IN,hold the Health Facility Administrator license(NO.14001002A) which status is Expired.
| Name | SURFACE, MARY J |
|---|---|
| License Number | 14001002A |
| License Type | Health Facility Administrator |
| License Status | Expired |
| City | WINGATE |
| State | IN |