The holder whose full name is Russel, Eric E,come from Cedar Lake IN,hold the Phys Ther Assistant license(NO.06004885A) which status is Active.
| Name | Russel, Eric E |
|---|---|
| License Number | 06004885A |
| License Type | Phys Ther Assistant |
| License Status | Active |
| City | Cedar Lake |
| State | IN |