The holder whose full name is Black, Jennifer Lynn,come from Bloomington IN,hold the Physician Assistant - Prescriptive Authority license(NO.10001094A) which status is Active.
| Name | Black, Jennifer Lynn |
|---|---|
| License Number | 10001094A |
| License Type | Physician Assistant - Prescriptive Authority |
| License Status | Active |
| City | Bloomington |
| State | IN |