The holder whose full name is Lenz, Dean Lawrence,come from Bloomington IN,hold the Temporary MD Permit license(NO.99033156A) which status is Superceded.
| Name | Lenz, Dean Lawrence |
|---|---|
| License Number | 99033156A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Bloomington |
| State | IN |