The holder whose full name is DeBerry, Diane Marie,come from Lafayette IN,hold the CSR-Prescriptive Authority license(NO.70000207B) which status is Expired.
| Name | DeBerry, Diane Marie |
|---|---|
| License Number | 70000207B |
| License Type | CSR-Prescriptive Authority |
| License Status | Expired |
| City | Lafayette |
| State | IN |