The holder whose full name is LEWELLEN, LILY I,come from FORT WAYNE IN,hold the Physical Therapist license(NO.05000143A) which status is Expired.
| Name | LEWELLEN, LILY I |
|---|---|
| License Number | 05000143A |
| License Type | Physical Therapist |
| License Status | Expired |
| City | FORT WAYNE |
| State | IN |