The holder whose full name is Mattox, Jacob Lee,come from Sellersburg IN,hold the Pharmacy Intern license(NO.45016720A) which status is Superceded.
| Name | Mattox, Jacob Lee |
|---|---|
| License Number | 45016720A |
| License Type | Pharmacy Intern |
| License Status | Superceded |
| City | Sellersburg |
| State | IN |