The holder whose full name is Urban, Donald A.,come from Fort Wayne IN,hold the Temporary MD Permit license(NO.99026248A) which status is Superceded.
| Name | Urban, Donald A. |
|---|---|
| License Number | 99026248A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Fort Wayne |
| State | IN |