The holder whose full name is Simmons, Walter Neil,come from Scottsdale AZ,hold the Temporary MD Permit license(NO.99053746A) which status is Superceded.
| Name | Simmons, Walter Neil |
|---|---|
| License Number | 99053746A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Scottsdale |
| State | AZ |