The holder whose full name is Melvin, Jerrold W.,come from Vincennes IN,hold the Preceptor Eligible license(NO.15004138A) which status is Expired.
| Name | Melvin, Jerrold W. |
|---|---|
| License Number | 15004138A |
| License Type | Preceptor Eligible |
| License Status | Expired |
| City | Vincennes |
| State | IN |