The holder whose full name is Horton Swartwelder, Lillian Jean,come from Fort Wayne IN,hold the Preceptor Eligible license(NO.15004417A) which status is Expired.
| Name | Horton Swartwelder, Lillian Jean |
|---|---|
| License Number | 15004417A |
| License Type | Preceptor Eligible |
| License Status | Expired |
| City | Fort Wayne |
| State | IN |