The holder whose full name is Lee, Edward S.,come from Munster IN,hold the Temporary DO Permit license(NO.99004656A) which status is Superceded.
| Name | Lee, Edward S. |
|---|---|
| License Number | 99004656A |
| License Type | Temporary DO Permit |
| License Status | Superceded |
| City | Munster |
| State | IN |