The holder whose full name is Igolnikov, Alexander Charles,come from Wilmette IL,hold the Temporary MD Permit license(NO.99052986A) which status is Superceded.
Name | Igolnikov, Alexander Charles |
---|---|
License Number | 99052986A |
License Type | Temporary MD Permit |
License Status | Superceded |
City | Wilmette |
State | IL |