The holder whose full name is Perez, Carmen,come from Chicago IL,hold the Temporary MD Permit license(NO.99056147A) which status is Superceded.
| Name | Perez, Carmen |
|---|---|
| License Number | 99056147A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Chicago |
| State | IL |