The holder whose full name is Ellis, Gail Lynn,come from Georgetown MA,hold the Temporary MD Permit license(NO.99006515A) which status is Superceded.
| Name | Ellis, Gail Lynn |
|---|---|
| License Number | 99006515A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Georgetown |
| State | MA |