The holder whose full name is FOULKE, TARA JAN,come from Brazil IN,hold the Physical Therapist license(NO.05005016A) which status is Active.
| Name | FOULKE, TARA JAN |
|---|---|
| License Number | 05005016A |
| License Type | Physical Therapist |
| License Status | Active |
| City | Brazil |
| State | IN |