The holder whose full name is Wilson, Dwayne LaFrantz,come from Providence RI,hold the Temporary MD Permit license(NO.99021865A) which status is Superceded.
| Name | Wilson, Dwayne LaFrantz |
|---|---|
| License Number | 99021865A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Providence |
| State | RI |