The holder whose full name is THOMAS, JACK E,come from BLOOMINGTON IN,hold the Psychologist - Health Service Provider license(NO.20010356A) which status is Active.
| Name | THOMAS, JACK E |
|---|---|
| License Number | 20010356A |
| License Type | Psychologist - Health Service Provider |
| License Status | Active |
| City | BLOOMINGTON |
| State | IN |