The holder whose full name is Bergeron, Michael H,come from Fort Wayne IN,hold the Temp Mental Hlth Coun Permit license(NO.99016459A) which status is Superceded.
| Name | Bergeron, Michael H |
|---|---|
| License Number | 99016459A |
| License Type | Temp Mental Hlth Coun Permit |
| License Status | Superceded |
| City | Fort Wayne |
| State | IN |