The holder whose full name is Boone, Kimberly Nicole,come from Portage IN,hold the Temp Mental Hlth Coun Permit license(NO.99044561A) which status is Expired.
| Name | Boone, Kimberly Nicole |
|---|---|
| License Number | 99044561A |
| License Type | Temp Mental Hlth Coun Permit |
| License Status | Expired |
| City | Portage |
| State | IN |