The holder whose full name is Ghazali, Mohammed S.,come from Fort Wayne IN,hold the Temporary MD Permit license(NO.99001795A) which status is Superceded.
Name | Ghazali, Mohammed S. |
---|---|
License Number | 99001795A |
License Type | Temporary MD Permit |
License Status | Superceded |
City | Fort Wayne |
State | IN |