The holder whose full name is Dagat, Mary Antonette,come from Terre Haute IN,hold the Temporary Occ Therapist Permit license(NO.99005806A) which status is Superceded.
| Name | Dagat, Mary Antonette |
|---|---|
| License Number | 99005806A |
| License Type | Temporary Occ Therapist Permit |
| License Status | Superceded |
| City | Terre Haute |
| State | IN |