Laserfiche WebLink
Indiana State D64parintent of Health <br />BARNEY L: BROOKS <br />Effective: 09/07/2012 <br />Birth Date: 09/13/1963 <br />Height: 5' 10" <br />Weight: 235 <br />.onvvno <br />1: 08/26/2022 <br />M <br />r: Brown <br />r: Black <br />tcrdf4: arc o4lniti,af Yzrddng.a' <br />Lead Renovator <br />Cart. No.: R-1-8885.79-19186 <br />laming Dates: 6101201916131x019 <br />Exam Cet4: 91012019 Langlu9e: English <br />CerUncado" Expl.s: 51312024 <br />1 .... dby: EnNanmCntd fdala�mc-nt lnslltte.lnc. <br />5010 CrewloMwM1e Rd Ste. 1500 <br />Indianapolis, IN. 46224-3787 <br />(317)$484840 <br />ed to: Barney Brooks <br />910 Leland Ave. <br />South Bend, IN 46616 <br />The Designated Representative of: - <br />HOUSE DOCTOR RENOVATIONS <br />Lead Contractor License # IND000330 <br />Effective: <br />08/26/2009 Expiration: 08/26/2022 <br />Birth Date: <br />Gender: <br />Height: <br />Eye Color: <br />Weight: <br />Hair Color: <br />Effective: 09/07/2012 <br />Birth Date: 09/13/1963 <br />Height: 5' 10" <br />Weight: 235 <br />.onvvno <br />1: 08/26/2022 <br />M <br />r: Brown <br />r: Black <br />tcrdf4: arc o4lniti,af Yzrddng.a' <br />Lead Renovator <br />Cart. No.: R-1-8885.79-19186 <br />laming Dates: 6101201916131x019 <br />Exam Cet4: 91012019 Langlu9e: English <br />CerUncado" Expl.s: 51312024 <br />1 .... dby: EnNanmCntd fdala�mc-nt lnslltte.lnc. <br />5010 CrewloMwM1e Rd Ste. 1500 <br />Indianapolis, IN. 46224-3787 <br />(317)$484840 <br />ed to: Barney Brooks <br />910 Leland Ave. <br />South Bend, IN 46616 <br />