The holder whose full name is Wagner, Christie Jo,come from New Haven IN,hold the Temporary PTA Permit license(NO.99051701A) which status is Superceded.
| Name | Wagner, Christie Jo |
|---|---|
| License Number | 99051701A |
| License Type | Temporary PTA Permit |
| License Status | Superceded |
| City | New Haven |
| State | IN |