The holder whose full name is Park, David H,come from Wethersfield CT,hold the Temporary DO Permit license(NO.99039475A) which status is Superceded.
| Name | Park, David H |
|---|---|
| License Number | 99039475A |
| License Type | Temporary DO Permit |
| License Status | Superceded |
| City | Wethersfield |
| State | CT |