The holder whose full name is Paunicka, Nancy Jane,come from Portage IN,hold the CSR-Prescriptive Authority license(NO.71000141B) which status is Active.
| Name | Paunicka, Nancy Jane |
|---|---|
| License Number | 71000141B |
| License Type | CSR-Prescriptive Authority |
| License Status | Active |
| City | Portage |
| State | IN |