The holder whose full name is Jacobs, Alfred Allen,come from Louisville KY,hold the Temporary MD Permit license(NO.99034855A) which status is Superceded.
| Name | Jacobs, Alfred Allen |
|---|---|
| License Number | 99034855A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Louisville |
| State | KY |