Louisiana
Board of Licensing
Crisp-Coleman Kodi Fay
Medical
License number
MD.204059
Date expires
09/30/2015
Class
Medical
Status
Active
Address
16220 Airline Hwy, Prairieville, LA 70769
louisianalicensing.com
ID 21897595
LAST UPDATED 2026-04-10 13:28:09 UTC
LAST UPDATED 2026-04-10 13:28:09 UTC