The holder whose full name is EDDY, LAVONNE MARIE,come from PERU IN,hold the CSR-Prescriptive Authority license(NO.71000301B) which status is Active.
| Name | EDDY, LAVONNE MARIE |
|---|---|
| License Number | 71000301B |
| License Type | CSR-Prescriptive Authority |
| License Status | Active |
| City | PERU |
| State | IN |