The holder whose full name is SMITH, JACK EDWARD,come from INDIANAPOLIS IN,hold the Physician Assistant license(NO.10000048A) which status is Expired.
| Name | SMITH, JACK EDWARD |
|---|---|
| License Number | 10000048A |
| License Type | Physician Assistant |
| License Status | Expired |
| City | INDIANAPOLIS |
| State | IN |