The holder whose full name is Trietsch, Samantha Louise,come from Fort Wayne IN,hold the Student Temp RCP license(NO.99014166A) which status is Superceded.
| Name | Trietsch, Samantha Louise |
|---|---|
| License Number | 99014166A |
| License Type | Student Temp RCP |
| License Status | Superceded |
| City | Fort Wayne |
| State | IN |