The holder whose full name is LaRussa, Michael Anthony,come from Indianapolis IN,hold the Pharmacy Technician license(NO.67014775A) which status is Expired.
| Name | LaRussa, Michael Anthony |
|---|---|
| License Number | 67014775A |
| License Type | Pharmacy Technician |
| License Status | Expired |
| City | Indianapolis |
| State | IN |