The holder whose full name is COLBERT, RICHARD W,come from SOUTH BEND IN,hold the Health Facility Administrator license(NO.14001146A) which status is Expired.
| Name | COLBERT, RICHARD W |
|---|---|
| License Number | 14001146A |
| License Type | Health Facility Administrator |
| License Status | Expired |
| City | SOUTH BEND |
| State | IN |