The holder whose full name is Bane, Channa N.,come from Portage IN,hold the Pharmacy Tech In-Training license(NO.99043457A) which status is Superceded.
| Name | Bane, Channa N. |
|---|---|
| License Number | 99043457A |
| License Type | Pharmacy Tech In-Training |
| License Status | Superceded |
| City | Portage |
| State | IN |