The holder whose full name is Razzouk, Bassem Ibrahim,come from Indianapolis IN,hold the Temporary MD Permit license(NO.99024734A) which status is Superceded.
| Name | Razzouk, Bassem Ibrahim |
|---|---|
| License Number | 99024734A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Indianapolis |
| State | IN |