The holder whose full name is Rivera, Mary L.,come from Portage IN,hold the Student Temp RCP license(NO.99018869A) which status is Superceded.
| Name | Rivera, Mary L. |
|---|---|
| License Number | 99018869A |
| License Type | Student Temp RCP |
| License Status | Superceded |
| City | Portage |
| State | IN |