The holder whose full name is Long, Jody Lynn,come from Valparaiso IN,hold the CSR-Prescriptive Authority license(NO.71003854B) which status is Active.
| Name | Long, Jody Lynn |
|---|---|
| License Number | 71003854B |
| License Type | CSR-Prescriptive Authority |
| License Status | Active |
| City | Valparaiso |
| State | IN |