The holder whose full name is Wallis, Amy Dawn,come from Washington IN,hold the CSR-Prescriptive Authority license(NO.71002282B) which status is Expired.
| Name | Wallis, Amy Dawn |
|---|---|
| License Number | 71002282B |
| License Type | CSR-Prescriptive Authority |
| License Status | Expired |
| City | Washington |
| State | IN |