The holder whose full name is Wenzel, Tara Lynn,come from Jasper IN,hold the Student Temp RCP license(NO.99056958A) which status is Superceded.
| Name | Wenzel, Tara Lynn |
|---|---|
| License Number | 99056958A |
| License Type | Student Temp RCP |
| License Status | Superceded |
| City | Jasper |
| State | IN |