The holder whose full name is Johnson, Beth Anne,come from Louisville KY,hold the Temporary MD Permit license(NO.99063086A) which status is Superceded.
| Name | Johnson, Beth Anne |
|---|---|
| License Number | 99063086A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Louisville |
| State | KY |