The holder whose full name is Summe, Lisa Mikulcik,come from Lawrenceburg IN,hold the Temporary MD Permit license(NO.99059530A) which status is Superceded.
| Name | Summe, Lisa Mikulcik |
|---|---|
| License Number | 99059530A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Lawrenceburg |
| State | IN |