The holder whose full name is OTT, DENNIS,come from MARION IN,hold the Preceptor Eligible license(NO.15003470A) which status is Expired.
| Name | OTT, DENNIS |
|---|---|
| License Number | 15003470A |
| License Type | Preceptor Eligible |
| License Status | Expired |
| City | MARION |
| State | IN |