The holder whose full name is Johnson, Kelly Rae,come from Bloomington IN,hold the Student Temp RCP license(NO.99012445A) which status is Superceded.
| Name | Johnson, Kelly Rae |
|---|---|
| License Number | 99012445A |
| License Type | Student Temp RCP |
| License Status | Superceded |
| City | Bloomington |
| State | IN |