The holder whose full name is Burgess, Amy Lynn,come from Winamac IN,hold the Temporary Occ Therapist Permit license(NO.99011728A) which status is Superceded.
| Name | Burgess, Amy Lynn |
|---|---|
| License Number | 99011728A |
| License Type | Temporary Occ Therapist Permit |
| License Status | Superceded |
| City | Winamac |
| State | IN |