The holder whose full name is Matuga, Theodore John,come from Bloomington MN,hold the Temporary MD Permit license(NO.99017013A) which status is Superceded.
| Name | Matuga, Theodore John |
|---|---|
| License Number | 99017013A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Bloomington |
| State | MN |