The holder whose full name is BROADNAX, LEILA ROSE,come from MERRILLVILLE IN,hold the Physical Therapist license(NO.05000777A) which status is Active.
| Name | BROADNAX, LEILA ROSE |
|---|---|
| License Number | 05000777A |
| License Type | Physical Therapist |
| License Status | Active |
| City | MERRILLVILLE |
| State | IN |