The holder whose full name is Koukal, Autumn Clarice,come from Lafayette IN,hold the Pharmacy Technician license(NO.67006416A) which status is Expired.
| Name | Koukal, Autumn Clarice |
|---|---|
| License Number | 67006416A |
| License Type | Pharmacy Technician |
| License Status | Expired |
| City | Lafayette |
| State | IN |