The holder whose full name is Forsythe, Brian,come from Westchester IL,hold the Temporary MD Permit license(NO.99062942A) which status is Active.
| Name | Forsythe, Brian |
|---|---|
| License Number | 99062942A |
| License Type | Temporary MD Permit |
| License Status | Active |
| City | Westchester |
| State | IL |