The holder whose full name is Bird, Autumn Nicole,come from Peru IN,hold the Pharmacy Tech In-Training license(NO.99036142A) which status is Superceded.
| Name | Bird, Autumn Nicole |
|---|---|
| License Number | 99036142A |
| License Type | Pharmacy Tech In-Training |
| License Status | Superceded |
| City | Peru |
| State | IN |