The holder whose full name is Casella, Anthony John,come from Scottsdale AZ,hold the Temporary MD Permit license(NO.99052476A) which status is Superceded.
| Name | Casella, Anthony John |
|---|---|
| License Number | 99052476A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Scottsdale |
| State | AZ |