The holder whose full name is Baccus, Frances Raquel,come from Elkhart IN,hold the Temporary MD Permit license(NO.99060029A) which status is Superceded.
| Name | Baccus, Frances Raquel |
|---|---|
| License Number | 99060029A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Elkhart |
| State | IN |