The holder whose full name is Shirley, Daniel Justin,come from Newport KY,hold the Temporary DO Permit license(NO.99057769A) which status is Superceded.
| Name | Shirley, Daniel Justin |
|---|---|
| License Number | 99057769A |
| License Type | Temporary DO Permit |
| License Status | Superceded |
| City | Newport |
| State | KY |