The holder whose full name is Collis, Dean Stanley,come from New Albany IN,hold the Temporary MD Permit license(NO.99000792A) which status is Superceded.
| Name | Collis, Dean Stanley |
|---|---|
| License Number | 99000792A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | New Albany |
| State | IN |