The holder whose full name is Levine, Scott Ian,come from Pendleton IN,hold the Temporary DO Permit license(NO.99003368A) which status is Superceded.
| Name | Levine, Scott Ian |
|---|---|
| License Number | 99003368A |
| License Type | Temporary DO Permit |
| License Status | Superceded |
| City | Pendleton |
| State | IN |