The holder whose full name is Black, Laura A.,come from Valparaiso IN,hold the Temp Clin Soc Worker Permit license(NO.99061033A) which status is Superceded.
| Name | Black, Laura A. |
|---|---|
| License Number | 99061033A |
| License Type | Temp Clin Soc Worker Permit |
| License Status | Superceded |
| City | Valparaiso |
| State | IN |