The holder whose full name is Wieringa, Ann Margaret,come from Elkhart IN,hold the Health Facility Administrator license(NO.14004380A) which status is Suspended.
| Name | Wieringa, Ann Margaret |
|---|---|
| License Number | 14004380A |
| License Type | Health Facility Administrator |
| License Status | Suspended |
| City | Elkhart |
| State | IN |