The holder whose full name is Staton, Harvey Thomas,come from Springfield OH,hold the Temporary MD Permit license(NO.99062136A) which status is Superceded.
| Name | Staton, Harvey Thomas |
|---|---|
| License Number | 99062136A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Springfield |
| State | OH |