The holder whose full name is Dietrick, John Adam,come from Tampa FL,hold the Temporary MD Permit license(NO.99014548A) which status is Superceded.
| Name | Dietrick, John Adam |
|---|---|
| License Number | 99014548A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Tampa |
| State | FL |