The holder whose full name is SIVAK III, MICHAEL J,come from Mishawaka IN,hold the Health Facility Administrator license(NO.14004338A) which status is Expired.
| Name | SIVAK III, MICHAEL J |
|---|---|
| License Number | 14004338A |
| License Type | Health Facility Administrator |
| License Status | Expired |
| City | Mishawaka |
| State | IN |