The holder whose full name is Gormal, Gregg Gordon,come from Indianapolis IN,hold the Preceptor Eligible license(NO.15004382A) which status is Expired.
| Name | Gormal, Gregg Gordon |
|---|---|
| License Number | 15004382A |
| License Type | Preceptor Eligible |
| License Status | Expired |
| City | Indianapolis |
| State | IN |