The holder whose full name is Blank, Tamara Lee,come from Plainfield IN,hold the Physician Assistant - Prescriptive Authority license(NO.10000435A) which status is Active.
| Name | Blank, Tamara Lee |
|---|---|
| License Number | 10000435A |
| License Type | Physician Assistant - Prescriptive Authority |
| License Status | Active |
| City | Plainfield |
| State | IN |