The holder whose full name is GO, JACOB TIONG,come from LAKE CHARLES LA,hold the Physician license(NO.01041574A) which status is Expired Non-Renewable.
| Name | GO, JACOB TIONG |
|---|---|
| License Number | 01041574A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | LAKE CHARLES |
| State | LA |