The holder whose full name is Jasiewicz, Regina Rose,come from SOUTH BEND IN,hold the CSR-Prescriptive Authority license(NO.71000519B) which status is Active.
| Name | Jasiewicz, Regina Rose |
|---|---|
| License Number | 71000519B |
| License Type | CSR-Prescriptive Authority |
| License Status | Active |
| City | SOUTH BEND |
| State | IN |