The holder whose full name is Baxter, Amanda Nicole,come from North Judson IN,hold the Student Temp RCP license(NO.99020168A) which status is Superceded.
| Name | Baxter, Amanda Nicole |
|---|---|
| License Number | 99020168A |
| License Type | Student Temp RCP |
| License Status | Superceded |
| City | North Judson |
| State | IN |