The holder whose full name is Borror, Kelly L.,come from Fort Wayne IN,hold the Preceptor Eligible license(NO.15003880A) which status is Active.
| Name | Borror, Kelly L. |
|---|---|
| License Number | 15003880A |
| License Type | Preceptor Eligible |
| License Status | Active |
| City | Fort Wayne |
| State | IN |