The holder whose full name is Black, Dawn Lyn,come from North Vernon IN,hold the Preceptor Eligible license(NO.15002699A) which status is Expired.
| Name | Black, Dawn Lyn |
|---|---|
| License Number | 15002699A |
| License Type | Preceptor Eligible |
| License Status | Expired |
| City | North Vernon |
| State | IN |