The holder whose full name is Sparks, Tia Shalaye,come from Portage IN,hold the Pharmacist license(NO.26021263A) which status is Active.
| Name | Sparks, Tia Shalaye |
|---|---|
| License Number | 26021263A |
| License Type | Pharmacist |
| License Status | Active |
| City | Portage |
| State | IN |