The holder whose full name is Werth, Lisa Bradley,come from Lafayette IN,hold the Temp Clin Soc Worker Permit license(NO.99008738A) which status is Superceded.
| Name | Werth, Lisa Bradley |
|---|---|
| License Number | 99008738A |
| License Type | Temp Clin Soc Worker Permit |
| License Status | Superceded |
| City | Lafayette |
| State | IN |