The holder whose full name is LACKEY, SUSAN JEAN,come from Portage IN,hold the Physical Therapist license(NO.05005752A) which status is Active.
| Name | LACKEY, SUSAN JEAN |
|---|---|
| License Number | 05005752A |
| License Type | Physical Therapist |
| License Status | Active |
| City | Portage |
| State | IN |