The holder whose full name is Ortiz, Mario Eugene,come from Fishers IN,hold the Temporary LPN Permit license(NO.99020614A) which status is Superceded.
| Name | Ortiz, Mario Eugene |
|---|---|
| License Number | 99020614A |
| License Type | Temporary LPN Permit |
| License Status | Superceded |
| City | Fishers |
| State | IN |