The holder whose full name is DEBARTOLO, JUDITH ANN,come from ELKHART IN,hold the Preceptor Eligible license(NO.15001813A) which status is Expired.
| Name | DEBARTOLO, JUDITH ANN |
|---|---|
| License Number | 15001813A |
| License Type | Preceptor Eligible |
| License Status | Expired |
| City | ELKHART |
| State | IN |