The holder whose full name is Ravita, John S.,come from Monroe GA,hold the Temporary MD Permit license(NO.99045785A) which status is Superceded.
| Name | Ravita, John S. |
|---|---|
| License Number | 99045785A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Monroe |
| State | GA |