The holder whose full name is Smith, Elizabeth Ellen,come from Valparaiso IN,hold the CSR-Prescriptive Authority license(NO.71004643B) which status is Active.
| Name | Smith, Elizabeth Ellen |
|---|---|
| License Number | 71004643B |
| License Type | CSR-Prescriptive Authority |
| License Status | Active |
| City | Valparaiso |
| State | IN |