The holder whose full name is Lewis, Shacola J,come from Crown Point IN,hold the Temporary LPN Permit license(NO.99055634A) which status is Superceded.
| Name | Lewis, Shacola J |
|---|---|
| License Number | 99055634A |
| License Type | Temporary LPN Permit |
| License Status | Superceded |
| City | Crown Point |
| State | IN |