The holder whose full name is Desmarais, Paul Herman,come from South Bend IN,hold the Temporary MD Permit license(NO.99000400A) which status is Superceded.
| Name | Desmarais, Paul Herman |
|---|---|
| License Number | 99000400A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | South Bend |
| State | IN |