The holder whose full name is Scollon, Richard Allen,come from Madison WI,hold the Health Facility Administrator license(NO.14004142A) which status is Suspended.
| Name | Scollon, Richard Allen |
|---|---|
| License Number | 14004142A |
| License Type | Health Facility Administrator |
| License Status | Suspended |
| City | Madison |
| State | WI |