The holder whose full name is Wade, Elaine Lee,come from River Forest IL,hold the Temporary MD Permit license(NO.99013309A) which status is Superceded.
| Name | Wade, Elaine Lee |
|---|---|
| License Number | 99013309A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | River Forest |
| State | IL |