The holder whose full name is Baldwin, Gail A.,come from Lafayette IN,hold the Preceptor Eligible - HFA license(NO.15900147A) which status is Expired.
Name | Baldwin, Gail A. |
---|---|
License Number | 15900147A |
License Type | Preceptor Eligible - HFA |
License Status | Expired |
City | Lafayette |
State | IN |