The holder whose full name is Thompson, Michael C.,come from Avon IN,hold the Preceptor Eligible license(NO.15004036A) which status is Expired.
| Name | Thompson, Michael C. |
|---|---|
| License Number | 15004036A |
| License Type | Preceptor Eligible |
| License Status | Expired |
| City | Avon |
| State | IN |