The holder whose full name is Fadare, Fawale Modupe,come from Marion IN,hold the CSR-Prescriptive Authority license(NO.70000156B) which status is Expired.
| Name | Fadare, Fawale Modupe |
|---|---|
| License Number | 70000156B |
| License Type | CSR-Prescriptive Authority |
| License Status | Expired |
| City | Marion |
| State | IN |