The holder whose full name is Smith, Douglas Frederick,come from Lexington KY,hold the Temporary MD Permit license(NO.99056226A) which status is Superceded.
| Name | Smith, Douglas Frederick |
|---|---|
| License Number | 99056226A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Lexington |
| State | KY |