The holder whose full name is FASSETT, GREGORY L,come from LOGANSPORT IN,hold the Preceptor Eligible license(NO.15002042A) which status is Expired.
| Name | FASSETT, GREGORY L |
|---|---|
| License Number | 15002042A |
| License Type | Preceptor Eligible |
| License Status | Expired |
| City | LOGANSPORT |
| State | IN |