The holder whose full name is Stout, Lisa E,come from La Porte IN,hold the CSR-Prescriptive Authority license(NO.72000124B) which status is Expired.
| Name | Stout, Lisa E |
|---|---|
| License Number | 72000124B |
| License Type | CSR-Prescriptive Authority |
| License Status | Expired |
| City | La Porte |
| State | IN |