The holder whose full name is Corrente, Lisa,come from New York NY,hold the Temporary MD Permit license(NO.99047555A) which status is Superceded.
| Name | Corrente, Lisa |
|---|---|
| License Number | 99047555A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | New York |
| State | NY |