The holder whose full name is Richardson, Gwen Ellen,come from West Lafayette IN,hold the CSR-Prescriptive Authority license(NO.71000365B) which status is Active.
| Name | Richardson, Gwen Ellen |
|---|---|
| License Number | 71000365B |
| License Type | CSR-Prescriptive Authority |
| License Status | Active |
| City | West Lafayette |
| State | IN |