The holder whose full name is Sample, Kenneth Maurice,come from Chesapeake VA,hold the Temporary MD Permit license(NO.99000499A) which status is Superceded.
| Name | Sample, Kenneth Maurice |
|---|---|
| License Number | 99000499A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Chesapeake |
| State | VA |