The holder whose full name is HENDERSON, AMY HALLAL,come from New Albany IN,hold the Temporary MD Permit license(NO.99000828A) which status is Superceded.
| Name | HENDERSON, AMY HALLAL |
|---|---|
| License Number | 99000828A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | New Albany |
| State | IN |