The holder whose full name is Grogg, Justin Robert,come from Fort Wayne IN,hold the Phys Ther Assistant license(NO.06003100A) which status is Expired.
| Name | Grogg, Justin Robert |
|---|---|
| License Number | 06003100A |
| License Type | Phys Ther Assistant |
| License Status | Expired |
| City | Fort Wayne |
| State | IN |