The holder whose full name is Rivera, Milagros T.,come from Prospect KY,hold the Temporary MD Permit license(NO.99014219A) which status is Superceded.
| Name | Rivera, Milagros T. |
|---|---|
| License Number | 99014219A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Prospect |
| State | KY |