The holder whose full name is Archie, Jackie B.,come from New Albany IN,hold the Temporary LPN Permit license(NO.99014410A) which status is Superceded.
Name | Archie, Jackie B. |
---|---|
License Number | 99014410A |
License Type | Temporary LPN Permit |
License Status | Superceded |
City | New Albany |
State | IN |