The holder whose full name is Weaver, Philip Jefferson,come from Houston TX,hold the Temporary MD Permit license(NO.99005122A) which status is Superceded.
| Name | Weaver, Philip Jefferson |
|---|---|
| License Number | 99005122A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Houston |
| State | TX |