The holder whose full name is JOHNSON, DAVID SHAUN,come from ZIONSVILLE IN,hold the Preceptor Eligible license(NO.15003604A) which status is Expired.
| Name | JOHNSON, DAVID SHAUN |
|---|---|
| License Number | 15003604A |
| License Type | Preceptor Eligible |
| License Status | Expired |
| City | ZIONSVILLE |
| State | IN |