The holder whose full name is Lake, Jason Michael,come from Gaithersburg MD,hold the Physician license(NO.01055969A) which status is Expired Non-Renewable.
| Name | Lake, Jason Michael |
|---|---|
| License Number | 01055969A |
| License Type | Physician |
| License Status | Expired Non-Renewable |
| City | Gaithersburg |
| State | MD |