The holder whose full name is Johnson, Tara Channel,come from Indianapolis IN,hold the Pharmacy Tech In-Training license(NO.99035097A) which status is Superceded.
| Name | Johnson, Tara Channel |
|---|---|
| License Number | 99035097A |
| License Type | Pharmacy Tech In-Training |
| License Status | Superceded |
| City | Indianapolis |
| State | IN |