The holder whose full name is Fair, Richard Innis,come from Mishawaka IN,hold the Health Facility Administrator license(NO.14003674A) which status is Inactive.
| Name | Fair, Richard Innis |
|---|---|
| License Number | 14003674A |
| License Type | Health Facility Administrator |
| License Status | Inactive |
| City | Mishawaka |
| State | IN |