The holder whose full name is Souder, David P.,come from Fort Wayne IN,hold the Preceptor Eligible license(NO.15001618A) which status is Active.
| Name | Souder, David P. |
|---|---|
| License Number | 15001618A |
| License Type | Preceptor Eligible |
| License Status | Active |
| City | Fort Wayne |
| State | IN |