The holder whose full name is Ford, Michael Douglas,come from Terre Haute IN,hold the Pharmacy Tech In-Training license(NO.99020572A) which status is Superceded.
| Name | Ford, Michael Douglas |
|---|---|
| License Number | 99020572A |
| License Type | Pharmacy Tech In-Training |
| License Status | Superceded |
| City | Terre Haute |
| State | IN |