The holder whose full name is WIETFELDT, MOLLY JEAN,come from Fort Wayne IN,hold the Temporary PTA Permit license(NO.99000240A) which status is Superceded.
| Name | WIETFELDT, MOLLY JEAN |
|---|---|
| License Number | 99000240A |
| License Type | Temporary PTA Permit |
| License Status | Superceded |
| City | Fort Wayne |
| State | IN |