The holder whose full name is Carroll, Jeffry Allen,come from Warsaw IN,hold the Preceptor Eligible license(NO.15004129A) which status is Expired.
| Name | Carroll, Jeffry Allen |
|---|---|
| License Number | 15004129A |
| License Type | Preceptor Eligible |
| License Status | Expired |
| City | Warsaw |
| State | IN |