The holder whose full name is Potgiesser, Nicholas Dale,come from South Bend IN,hold the Temporary PTA Permit license(NO.99015234A) which status is Superceded.
| Name | Potgiesser, Nicholas Dale |
|---|---|
| License Number | 99015234A |
| License Type | Temporary PTA Permit |
| License Status | Superceded |
| City | South Bend |
| State | IN |