The holder whose full name is Smith, Rosa M,come from Crown Point IN,hold the Temporary Occ Therapist Permit license(NO.99017700A) which status is Superceded.
| Name | Smith, Rosa M |
|---|---|
| License Number | 99017700A |
| License Type | Temporary Occ Therapist Permit |
| License Status | Superceded |
| City | Crown Point |
| State | IN |