The holder whose full name is Beaulieu, Amy Annette,come from Bloomington IN,hold the Temp Clin Soc Worker Permit license(NO.99054705A) which status is Superceded.
| Name | Beaulieu, Amy Annette |
|---|---|
| License Number | 99054705A |
| License Type | Temp Clin Soc Worker Permit |
| License Status | Superceded |
| City | Bloomington |
| State | IN |