The holder whose full name is DeGutis, Dorothea Lynn,come from Brattleboro VT,hold the Temporary MD Permit license(NO.99032998A) which status is Superceded.
Name | DeGutis, Dorothea Lynn |
---|---|
License Number | 99032998A |
License Type | Temporary MD Permit |
License Status | Superceded |
City | Brattleboro |
State | VT |