The holder whose full name is Clark, Faron Travis,come from Clinton IN,hold the Phys Ther Assistant license(NO.06002204A) which status is Active.
| Name | Clark, Faron Travis |
|---|---|
| License Number | 06002204A |
| License Type | Phys Ther Assistant |
| License Status | Active |
| City | Clinton |
| State | IN |