The holder whose full name is ROTHENBERG, GERALD,come from GARY IN,hold the Preceptor Eligible license(NO.15000622A) which status is Expired.
| Name | ROTHENBERG, GERALD |
|---|---|
| License Number | 15000622A |
| License Type | Preceptor Eligible |
| License Status | Expired |
| City | GARY |
| State | IN |