The holder whose full name is Roth, Jason David,come from Avon IN,hold the Physician Assistant - Prescriptive Authority license(NO.10000474A) which status is Active.
| Name | Roth, Jason David |
|---|---|
| License Number | 10000474A |
| License Type | Physician Assistant - Prescriptive Authority |
| License Status | Active |
| City | Avon |
| State | IN |