The holder whose full name is Lewis, Samantha Kay,come from Churubusco IN,hold the Pharmacy Tech In-Training license(NO.99027029A) which status is Superceded.
| Name | Lewis, Samantha Kay |
|---|---|
| License Number | 99027029A |
| License Type | Pharmacy Tech In-Training |
| License Status | Superceded |
| City | Churubusco |
| State | IN |