The holder whose full name is WAGNER, GLENN E,come from VALPARAISO IN,hold the Preceptor Eligible license(NO.15002553A) which status is Expired.
| Name | WAGNER, GLENN E |
|---|---|
| License Number | 15002553A |
| License Type | Preceptor Eligible |
| License Status | Expired |
| City | VALPARAISO |
| State | IN |