The holder whose full name is Pena, Elpidio DeJesus,come from Louisville KY,hold the Temporary MD Permit license(NO.99060969A) which status is Superceded.
| Name | Pena, Elpidio DeJesus |
|---|---|
| License Number | 99060969A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Louisville |
| State | KY |