The holder whose full name is Polly, Amy Carol,come from Lafayette IN,hold the Pharmacy Tech In-Training license(NO.99038487A) which status is Superceded.
| Name | Polly, Amy Carol |
|---|---|
| License Number | 99038487A |
| License Type | Pharmacy Tech In-Training |
| License Status | Superceded |
| City | Lafayette |
| State | IN |