The holder whose full name is Smith, Andrea Jeanette,come from Fort Wayne IN,hold the Physical Therapist license(NO.05004800A) which status is Expired.
| Name | Smith, Andrea Jeanette |
|---|---|
| License Number | 05004800A |
| License Type | Physical Therapist |
| License Status | Expired |
| City | Fort Wayne |
| State | IN |