Louisiana
Board of Licensing
DE CHAMPLAIN STACI BAKER
Medical
License number
OTA.Z20640
Date expires
08/31/2015
Class
Medical
Status
Active
Address
305 Texas, Mansfield, LA 71052
louisianalicensing.com
ID 21981980
LAST UPDATED 2024-03-22 14:26:48 UTC
LAST UPDATED 2024-03-22 14:26:48 UTC