The holder whose full name is Horchak, Alex Michael,come from Bellevue IA,hold the Temporary MD Permit license(NO.99041720A) which status is Superceded.
Name | Horchak, Alex Michael |
---|---|
License Number | 99041720A |
License Type | Temporary MD Permit |
License Status | Superceded |
City | Bellevue |
State | IA |