The holder whose full name is Gentil, Tami Ann,come from Fort Wayne IN,hold the Temp Clin Soc Worker Permit license(NO.99055498A) which status is Superceded.
| Name | Gentil, Tami Ann |
|---|---|
| License Number | 99055498A |
| License Type | Temp Clin Soc Worker Permit |
| License Status | Superceded |
| City | Fort Wayne |
| State | IN |