The holder whose full name is Bernardi, Diane Marie,come from Fort Wayne IN,hold the Temporary MD Permit license(NO.99000975A) which status is Superceded.
| Name | Bernardi, Diane Marie |
|---|---|
| License Number | 99000975A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Fort Wayne |
| State | IN |