The holder whose full name is NIX, TIMOTHY HOW,come from MUNSTER IN,hold the Preceptor Eligible license(NO.15002808A) which status is Expired.
| Name | NIX, TIMOTHY HOW |
|---|---|
| License Number | 15002808A |
| License Type | Preceptor Eligible |
| License Status | Expired |
| City | MUNSTER |
| State | IN |