The holder whose full name is LAKE, THERESA MARIE,come from O Fallon IL,hold the Registered Nurse license(NO.28103461A) which status is Expired.
| Name | LAKE, THERESA MARIE |
|---|---|
| License Number | 28103461A |
| License Type | Registered Nurse |
| License Status | Expired |
| City | O Fallon |
| State | IL |