The holder whose full name is Prosser, Diane Johnson,come from South Bend IN,hold the Psychologist - Health Service Provider license(NO.20040993A) which status is Active.
| Name | Prosser, Diane Johnson |
|---|---|
| License Number | 20040993A |
| License Type | Psychologist - Health Service Provider |
| License Status | Active |
| City | South Bend |
| State | IN |