The holder whose full name is Banlasan, Joseph Tan,come from Lafayette IN,hold the Occupational Therapist license(NO.31004329A) which status is Expired.
| Name | Banlasan, Joseph Tan |
|---|---|
| License Number | 31004329A |
| License Type | Occupational Therapist |
| License Status | Expired |
| City | Lafayette |
| State | IN |