The holder whose full name is Bautista, Miriam,come from Cedar Lake IN,hold the Temporary LPN Permit license(NO.99060275A) which status is Superceded.
| Name | Bautista, Miriam |
|---|---|
| License Number | 99060275A |
| License Type | Temporary LPN Permit |
| License Status | Superceded |
| City | Cedar Lake |
| State | IN |