The holder whose full name is Dittmer, Mavis,come from West Harrison IN,hold the Temporary LPN Permit license(NO.99014895A) which status is Superceded.
| Name | Dittmer, Mavis |
|---|---|
| License Number | 99014895A |
| License Type | Temporary LPN Permit |
| License Status | Superceded |
| City | West Harrison |
| State | IN |