The holder whose full name is Bohman, Michelle Lynnette,come from Cedar Grove IN,hold the Student Temp RCP license(NO.99004297A) which status is Superceded.
| Name | Bohman, Michelle Lynnette |
|---|---|
| License Number | 99004297A |
| License Type | Student Temp RCP |
| License Status | Superceded |
| City | Cedar Grove |
| State | IN |