The holder whose full name is THOMAS, LORA,come from FORT WAYNE IN,hold the Preceptor Eligible license(NO.15002499A) which status is Expired.
| Name | THOMAS, LORA |
|---|---|
| License Number | 15002499A |
| License Type | Preceptor Eligible |
| License Status | Expired |
| City | FORT WAYNE |
| State | IN |