The holder whose full name is Black, Deronda Ann,come from Vicksburg MI,hold the Occupational Therapist license(NO.31004281A) which status is Active.
| Name | Black, Deronda Ann |
|---|---|
| License Number | 31004281A |
| License Type | Occupational Therapist |
| License Status | Active |
| City | Vicksburg |
| State | MI |