The holder whose full name is GREENWELL, RUTH ANN,come from LOOGOOTEE IN,hold the Preceptor Eligible license(NO.15002875A) which status is Expired.
| Name | GREENWELL, RUTH ANN |
|---|---|
| License Number | 15002875A |
| License Type | Preceptor Eligible |
| License Status | Expired |
| City | LOOGOOTEE |
| State | IN |