The holder whose full name is DeTienne, Leslie A.,come from Portage IN,hold the Massage Therapist license(NO.MT20901373) which status is Expired.
| Name | DeTienne, Leslie A. |
|---|---|
| License Number | MT20901373 |
| License Type | Massage Therapist |
| License Status | Expired |
| City | Portage |
| State | IN |