The holder whose full name is Long, Eugene Roy,come from Chattanooga TN,hold the Temporary MD Permit license(NO.99008059A) which status is Superceded.
| Name | Long, Eugene Roy |
|---|---|
| License Number | 99008059A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Chattanooga |
| State | TN |