The holder whose full name is Jackson, Amanda Lynn,come from Greenwood IN,hold the Student Temp RCP license(NO.99052653A) which status is Superceded.
| Name | Jackson, Amanda Lynn |
|---|---|
| License Number | 99052653A |
| License Type | Student Temp RCP |
| License Status | Superceded |
| City | Greenwood |
| State | IN |