The holder whose full name is Ingram, Marie Elaine,come from Jasper IN,hold the Temp Clin Soc Worker Permit license(NO.99012240A) which status is Expired.
| Name | Ingram, Marie Elaine |
|---|---|
| License Number | 99012240A |
| License Type | Temp Clin Soc Worker Permit |
| License Status | Expired |
| City | Jasper |
| State | IN |