The holder whose full name is Long, ShaVonna, L,come from Indianapolis IN,hold the Pharmacy Tech In-Training license(NO.99050104A) which status is Superceded.
| Name | Long, ShaVonna, L |
|---|---|
| License Number | 99050104A |
| License Type | Pharmacy Tech In-Training |
| License Status | Superceded |
| City | Indianapolis |
| State | IN |