The holder whose full name is BLACK SCHAFFER, ALICE E,come from BLOOMINGTON IN,hold the Physician license(NO.01022414A) which status is Expired Non-Renewable.
| Name | BLACK SCHAFFER, ALICE E |
|---|---|
| License Number | 01022414A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | BLOOMINGTON |
| State | IN |