The holder whose full name is Lazarus, Lawrence,come from Chicago IL,hold the Temporary MD Permit license(NO.99004138A) which status is Superceded.
| Name | Lazarus, Lawrence |
|---|---|
| License Number | 99004138A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Chicago |
| State | IL |