The holder whose full name is List, Benjamin D.,come from Covington KY,hold the CSR-Prescriptive Authority license(NO.71004343B) which status is Active.
| Name | List, Benjamin D. |
|---|---|
| License Number | 71004343B |
| License Type | CSR-Prescriptive Authority |
| License Status | Active |
| City | Covington |
| State | KY |