The holder whose full name is Wallace, Catherine Lorene,come from Fort Wayne IN,hold the Temporary RCP Permit license(NO.99012664A) which status is Superceded.
| Name | Wallace, Catherine Lorene |
|---|---|
| License Number | 99012664A |
| License Type | Temporary RCP Permit |
| License Status | Superceded |
| City | Fort Wayne |
| State | IN |