The holder whose full name is SALUD, ANTONIO DE VILLA,come from Valparaiso IN,hold the Temporary MD Permit license(NO.99003214A) which status is Superceded.
| Name | SALUD, ANTONIO DE VILLA |
|---|---|
| License Number | 99003214A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Valparaiso |
| State | IN |