The holder whose full name is Artin, Bassel,come from Lafayette IN,hold the Temporary MD Permit license(NO.99057919A) which status is Superceded.
| Name | Artin, Bassel |
|---|---|
| License Number | 99057919A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Lafayette |
| State | IN |