The holder whose full name is Smith, Phyllis Lee,come from Poland IN,hold the CSR-Prescriptive Authority license(NO.71001462B) which status is Expired.
| Name | Smith, Phyllis Lee |
|---|---|
| License Number | 71001462B |
| License Type | CSR-Prescriptive Authority |
| License Status | Expired |
| City | Poland |
| State | IN |