The holder whose full name is Malden, Ephphatha,come from Gary IN,hold the Temp Clin Soc Worker Permit license(NO.99049419A) which status is Expired.
| Name | Malden, Ephphatha |
|---|---|
| License Number | 99049419A |
| License Type | Temp Clin Soc Worker Permit |
| License Status | Expired |
| City | Gary |
| State | IN |