The holder whose full name is Lucas, Samantha Michelle,come from Columbus IN,hold the Temporary MD Permit license(NO.99037182A) which status is Superceded.
| Name | Lucas, Samantha Michelle |
|---|---|
| License Number | 99037182A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Columbus |
| State | IN |