The holder whose full name is BLANK, LAVERNE WAYNE,come from NILES MI,hold the Podiatrist license(NO.07000299A) which status is Expired.
| Name | BLANK, LAVERNE WAYNE |
|---|---|
| License Number | 07000299A |
| License Type | Podiatrist |
| License Status | Expired |
| City | NILES |
| State | MI |