The holder whose full name is WAGNER, PHYLLIS A.,come from CYNTHIANA IN,hold the Health Facility Administrator license(NO.14000116A) which status is Expired.
| Name | WAGNER, PHYLLIS A. |
|---|---|
| License Number | 14000116A |
| License Type | Health Facility Administrator |
| License Status | Expired |
| City | CYNTHIANA |
| State | IN |