The holder whose full name is LAKES, LARRY G,come from ELKHART IN,hold the Preceptor Eligible license(NO.15003259A) which status is Expired.
| Name | LAKES, LARRY G |
|---|---|
| License Number | 15003259A |
| License Type | Preceptor Eligible |
| License Status | Expired |
| City | ELKHART |
| State | IN |