The holder whose full name is Borok, Thomas Louis,come from Dallas TX,hold the Temporary MD Permit license(NO.99001213A) which status is Superceded.
| Name | Borok, Thomas Louis |
|---|---|
| License Number | 99001213A |
| License Type | Temporary MD Permit |
| License Status | Superceded |
| City | Dallas |
| State | TX |