The holder whose full name is Fodstad, Jill,come from Indianapolis IN,hold the Psychologist - Health Service Provider license(NO.20042696A) which status is Active.
| Name | Fodstad, Jill |
|---|---|
| License Number | 20042696A |
| License Type | Psychologist - Health Service Provider |
| License Status | Active |
| City | Indianapolis |
| State | IN |