The holder whose full name is Lane, Michael Wendell,come from Richmond VA,hold the Temporary MD Permit license(NO.99037069A) which status is Superceded.
| Name | Lane, Michael Wendell |
|---|---|
| License Number | 99037069A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Richmond |
| State | VA |