The holder whose full name is Weise, Amy M.,come from South Bend IN,hold the Temporary DO Permit license(NO.99040140A) which status is Expired.
| Name | Weise, Amy M. |
|---|---|
| License Number | 99040140A |
| License Type | Temporary DO Permit |
| License Status | Expired |
| City | South Bend |
| State | IN |