The holder whose full name is Moon, Lisa Maria,come from Fort Wayne IN,hold the SLP Support Personnel - Aide license(NO.29001052A) which status is Expired.
| Name | Moon, Lisa Maria |
|---|---|
| License Number | 29001052A |
| License Type | SLP Support Personnel - Aide |
| License Status | Expired |
| City | Fort Wayne |
| State | IN |