The holder whose full name is Sparks, Kelly Leroy,come from Fort Branch IN,hold the Physician Assistant - Prescriptive Authority license(NO.10000928A) which status is Active.
| Name | Sparks, Kelly Leroy |
|---|---|
| License Number | 10000928A |
| License Type | Physician Assistant - Prescriptive Authority |
| License Status | Active |
| City | Fort Branch |
| State | IN |