The holder whose full name is Paino, Timothy D.,come from Avon IN,hold the Preceptor Eligible license(NO.15001454A) which status is Active.
| Name | Paino, Timothy D. |
|---|---|
| License Number | 15001454A |
| License Type | Preceptor Eligible |
| License Status | Active |
| City | Avon |
| State | IN |