The holder whose full name is LAI, CHARLES KANSEN,come from Kokomo IN,hold the Temporary MD Permit license(NO.99002263A) which status is Superceded.
| Name | LAI, CHARLES KANSEN |
|---|---|
| License Number | 99002263A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Kokomo |
| State | IN |