The holder whose full name is JACKSON, LISA,come from WEST LAFAYETTE IN,hold the Physical Therapist license(NO.05001470A) which status is Expired.
| Name | JACKSON, LISA |
|---|---|
| License Number | 05001470A |
| License Type | Physical Therapist |
| License Status | Expired |
| City | WEST LAFAYETTE |
| State | IN |