The holder whose full name is POWELL, JAN LEE,come from MADISON IN,hold the CSR-Prescriptive Authority license(NO.71000816B) which status is Expired.
| Name | POWELL, JAN LEE |
|---|---|
| License Number | 71000816B |
| License Type | CSR-Prescriptive Authority |
| License Status | Expired |
| City | MADISON |
| State | IN |