The holder whose full name is Miller, Terry Alan,come from Newburgh IN,hold the Preceptor Eligible license(NO.15002004A) which status is Expired.
| Name | Miller, Terry Alan |
|---|---|
| License Number | 15002004A |
| License Type | Preceptor Eligible |
| License Status | Expired |
| City | Newburgh |
| State | IN |