The holder whose full name is Samant, Prachee Prakash,come from Fort Wayne IN,hold the Temp Mental Hlth Coun Permit license(NO.99042557A) which status is Expired.
| Name | Samant, Prachee Prakash |
|---|---|
| License Number | 99042557A |
| License Type | Temp Mental Hlth Coun Permit |
| License Status | Expired |
| City | Fort Wayne |
| State | IN |