The holder whose full name is Lentsch, Eric J.,come from Georgetown IN,hold the Temporary MD Permit license(NO.99006952A) which status is Superceded.
| Name | Lentsch, Eric J. |
|---|---|
| License Number | 99006952A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Georgetown |
| State | IN |