The holder whose full name is Ingrum, Laura Michelle,come from DPO AP,hold the CSR-Prescriptive Authority license(NO.71001999B) which status is Expired.
| Name | Ingrum, Laura Michelle |
|---|---|
| License Number | 71001999B |
| License Type | CSR-Prescriptive Authority |
| License Status | Expired |
| City | DPO |
| State | AP |