The holder whose full name is CLARK, DEBRA LYNN,come from SHELBYVILLE IN,hold the Medical Residency Permit license(NO.11004751A) which status is Expired.
| Name | CLARK, DEBRA LYNN |
|---|---|
| License Number | 11004751A |
| License Type | Medical Residency Permit |
| License Status | Expired |
| City | SHELBYVILLE |
| State | IN |