The holder whose full name is Terry, Geraldine Jacobus,come from Merrillville IN,hold the Temporary MD Permit license(NO.99014736A) which status is Superceded.
| Name | Terry, Geraldine Jacobus |
|---|---|
| License Number | 99014736A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Merrillville |
| State | IN |