The holder whose full name is Long, Lara Anne,come from Terre Haute IN,hold the Pharmacy Intern license(NO.45016261A) which status is Superceded.
| Name | Long, Lara Anne |
|---|---|
| License Number | 45016261A |
| License Type | Pharmacy Intern |
| License Status | Superceded |
| City | Terre Haute |
| State | IN |