The holder whose full name is Ice, Daniel Scott,come from Philadelphia PA,hold the Medical Residency Permit license(NO.11014293A) which status is Superceded.
| Name | Ice, Daniel Scott |
|---|---|
| License Number | 11014293A |
| License Type | Medical Residency Permit |
| License Status | Superceded |
| City | Philadelphia |
| State | PA |