The holder whose full name is Liberty, Donald Robert,come from Folsom CA,hold the Dental Intern Permit license(NO.42000199A) which status is Superceded.
| Name | Liberty, Donald Robert |
|---|---|
| License Number | 42000199A |
| License Type | Dental Intern Permit |
| License Status | Superceded |
| City | Folsom |
| State | CA |