The holder whose full name is Green, Tanya,come from Fort Wayne IN,hold the Temp Clin Soc Worker Permit license(NO.99018606A) which status is Superceded.
| Name | Green, Tanya |
|---|---|
| License Number | 99018606A |
| License Type | Temp Clin Soc Worker Permit |
| License Status | Superceded |
| City | Fort Wayne |
| State | IN |