The holder whose full name is Smith, Charles Edward,come from Newburgh IN,hold the Psychologist - Health Service Provider license(NO.20040012A) which status is Active.
| Name | Smith, Charles Edward |
|---|---|
| License Number | 20040012A |
| License Type | Psychologist - Health Service Provider |
| License Status | Active |
| City | Newburgh |
| State | IN |