The holder whose full name is Ketchem, Alice Camille,come from Indianapolis IN,hold the CSR-Prescriptive Authority license(NO.71003805B) which status is Active.
| Name | Ketchem, Alice Camille |
|---|---|
| License Number | 71003805B |
| License Type | CSR-Prescriptive Authority |
| License Status | Active |
| City | Indianapolis |
| State | IN |