The holder whose full name is Pak, Michael,come from Dayton OH,hold the Temporary MD Permit license(NO.99004461A) which status is Superceded.
| Name | Pak, Michael |
|---|---|
| License Number | 99004461A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Dayton |
| State | OH |