The holder whose full name is Briggs, Edwin Manley,come from Boise ID,hold the Temporary MD Permit license(NO.99060692A) which status is Superceded.
| Name | Briggs, Edwin Manley |
|---|---|
| License Number | 99060692A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Boise |
| State | ID |