SAN JOSE, Calif.—Elizabeth Holmes took the look stand Friday afternoon to defend herself against prison-fraud costs tied to the failure of Theranos Inc., the startup she founded in 2003 as a 19-year-frail college dropout.

Ms. Holmes, who appeared peaceable and polished, opened her testimony at the starting of the Theranos memoir: discussing her laboratory work as a faculty freshman at Stanford College, the mentorship she bought from a Stanford professor and her imaginative and prescient even as a teen to commerce healthcare. Her look—unmasked for the first time in court—energized a case that is heading against its 12th week of testimony.

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