The holder whose full name is Grogg, Justin Robert,come from Fort Wayne IN,hold the Temporary PTA Permit license(NO.99008479A) which status is Superceded.
| Name | Grogg, Justin Robert |
|---|---|
| License Number | 99008479A |
| License Type | Temporary PTA Permit |
| License Status | Superceded |
| City | Fort Wayne |
| State | IN |