The holder whose full name is Lay, Jack Francis,come from Austin TX,hold the Temporary MD Permit license(NO.99000404A) which status is Superceded.
| Name | Lay, Jack Francis |
|---|---|
| License Number | 99000404A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Austin |
| State | TX |