The holder whose full name is Johnson, Tanisha Marie,come from Indianapolis IN,hold the Student Temp RCP license(NO.99008788A) which status is Superceded.
| Name | Johnson, Tanisha Marie |
|---|---|
| License Number | 99008788A |
| License Type | Student Temp RCP |
| License Status | Superceded |
| City | Indianapolis |
| State | IN |