The holder whose full name is Rivera, David A,come from Lombard IL,hold the Temporary MD Permit license(NO.99013092A) which status is Superceded.
| Name | Rivera, David A |
|---|---|
| License Number | 99013092A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Lombard |
| State | IL |