The holder whose full name is PETERSEN, JOHN ANTHONY,come from South Bend IN,hold the Psychologist - Health Service Provider license(NO.20041594A) which status is Active.
| Name | PETERSEN, JOHN ANTHONY |
|---|---|
| License Number | 20041594A |
| License Type | Psychologist - Health Service Provider |
| License Status | Active |
| City | South Bend |
| State | IN |