The holder whose full name is Bousum, Regina Lee,come from Walton IN,hold the Pharmacy Technician license(NO.67009079A) which status is Active.
| Name | Bousum, Regina Lee |
|---|---|
| License Number | 67009079A |
| License Type | Pharmacy Technician |
| License Status | Active |
| City | Walton |
| State | IN |