The holder whose full name is Basemore, Vincent Ray,come from Gary IN,hold the Temporary PTA Permit license(NO.99032634A) which status is Superceded.
| Name | Basemore, Vincent Ray |
|---|---|
| License Number | 99032634A |
| License Type | Temporary PTA Permit |
| License Status | Superceded |
| City | Gary |
| State | IN |