The holder whose full name is Black, Laurie Ann,come from Franklin IN,hold the Temporary RCP Permit license(NO.99026967A) which status is Superceded.
| Name | Black, Laurie Ann |
|---|---|
| License Number | 99026967A |
| License Type | Temporary RCP Permit |
| License Status | Superceded |
| City | Franklin |
| State | IN |