The holder whose full name is PANBAMRUNG, ANTHONY KHUNTONG,come from Fort Wayne IN,hold the Temporary PTA Permit license(NO.99002518A) which status is Superceded.
| Name | PANBAMRUNG, ANTHONY KHUNTONG |
|---|---|
| License Number | 99002518A |
| License Type | Temporary PTA Permit |
| License Status | Superceded |
| City | Fort Wayne |
| State | IN |