The holder whose full name is PHUNG, MAI TU,come from Muncie IN,hold the Temporary DO Permit license(NO.99002139A) which status is Superceded.
| Name | PHUNG, MAI TU |
|---|---|
| License Number | 99002139A |
| License Type | Temporary DO Permit |
| License Status | Superceded |
| City | Muncie |
| State | IN |