The holder whose full name is Fogelson, Bernard Gerald,come from Indianapolis IN,hold the Temporary MD Permit license(NO.99009319A) which status is Superceded.
| Name | Fogelson, Bernard Gerald |
|---|---|
| License Number | 99009319A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Indianapolis |
| State | IN |