The holder whose full name is CLARK, BRUCE LANE,come from GREENWOOD IN,hold the Health Facility Administrator license(NO.14002357A) which status is Expired.
| Name | CLARK, BRUCE LANE |
|---|---|
| License Number | 14002357A |
| License Type | Health Facility Administrator |
| License Status | Expired |
| City | GREENWOOD |
| State | IN |