The holder whose full name is Blake, Mary Ellen,come from Loogootee IN,hold the Phys Ther Assistant license(NO.06000086A) which status is Active.
| Name | Blake, Mary Ellen |
|---|---|
| License Number | 06000086A |
| License Type | Phys Ther Assistant |
| License Status | Active |
| City | Loogootee |
| State | IN |