The holder whose full name is Boutelle, Ronald Wayne,come from Georgetown IN,hold the Temporary LPN Permit license(NO.99063525A) which status is Superceded.
| Name | Boutelle, Ronald Wayne |
|---|---|
| License Number | 99063525A |
| License Type | Temporary LPN Permit |
| License Status | Superceded |
| City | Georgetown |
| State | IN |