The holder whose full name is Barnes, Jeremy Patrick,come from Bloomington IN,hold the Student Temp RCP license(NO.99053778A) which status is Superceded.
| Name | Barnes, Jeremy Patrick |
|---|---|
| License Number | 99053778A |
| License Type | Student Temp RCP |
| License Status | Superceded |
| City | Bloomington |
| State | IN |