The holder whose full name is Medina, Jorge M.,come from Seattle WA,hold the Temporary MD Permit license(NO.99005461A) which status is Superceded.
| Name | Medina, Jorge M. |
|---|---|
| License Number | 99005461A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Seattle |
| State | WA |