The holder whose full name is Clark, Melinda Ann,come from Rockport IN,hold the CSR-Prescriptive Authority license(NO.71005040B) which status is Active.
| Name | Clark, Melinda Ann |
|---|---|
| License Number | 71005040B |
| License Type | CSR-Prescriptive Authority |
| License Status | Active |
| City | Rockport |
| State | IN |