The holder whose full name is Embuscado, Emmanuel Evangelista,come from Lafayette IN,hold the Pharmacy Intern license(NO.45015390A) which status is Superceded.
| Name | Embuscado, Emmanuel Evangelista |
|---|---|
| License Number | 45015390A |
| License Type | Pharmacy Intern |
| License Status | Superceded |
| City | Lafayette |
| State | IN |