The holder whose full name is Lee, Kelly Sue,come from Bloomington IN,hold the Student Temp RCP license(NO.99033296A) which status is Superceded.
| Name | Lee, Kelly Sue |
|---|---|
| License Number | 99033296A |
| License Type | Student Temp RCP |
| License Status | Superceded |
| City | Bloomington |
| State | IN |