LR60500086 | ASC gov

Active

Inactive

Effective Date of Credential

Thu, 02/24/2005 - 12:00

Expiration Date of Credential

Mon, 06/30/2008 - 12:00

Conforms to AQB

No

ID

208561

Certification Type

Licensed

City

Fort Wayne

State/Province

IN

Zip

46835

County

Allen

State