The holder whose full name is MERRELL, THERESA ANNE,come from KOKOMO IN,hold the Preceptor Eligible license(NO.15002871A) which status is Expired.
| Name | MERRELL, THERESA ANNE |
|---|---|
| License Number | 15002871A |
| License Type | Preceptor Eligible |
| License Status | Expired |
| City | KOKOMO |
| State | IN |