The holder whose full name is Palmer, Tiffany A.,come from Portage IN,hold the Temporary PTA Permit license(NO.99022068A) which status is Superceded.
| Name | Palmer, Tiffany A. |
|---|---|
| License Number | 99022068A |
| License Type | Temporary PTA Permit |
| License Status | Superceded |
| City | Portage |
| State | IN |