The holder whose full name is TITTMAN, PHYLLIS JEAN,come from FORT WAYNE IN,hold the Health Facility Administrator license(NO.14002149A) which status is Expired.
| Name | TITTMAN, PHYLLIS JEAN |
|---|---|
| License Number | 14002149A |
| License Type | Health Facility Administrator |
| License Status | Expired |
| City | FORT WAYNE |
| State | IN |