The holder whose full name is Cooper, Chad Phillip,come from Jeffersonville IN,hold the Student Temp RCP license(NO.99043187A) which status is Superceded.
| Name | Cooper, Chad Phillip |
|---|---|
| License Number | 99043187A |
| License Type | Student Temp RCP |
| License Status | Superceded |
| City | Jeffersonville |
| State | IN |