The holder whose full name is Leis, Christopher S.,come from Salem IN,hold the Student Temp RCP license(NO.99057403A) which status is Superceded.
| Name | Leis, Christopher S. |
|---|---|
| License Number | 99057403A |
| License Type | Student Temp RCP |
| License Status | Superceded |
| City | Salem |
| State | IN |