1FDXE45P04HA78360
Vehicle Board in Florida

License number
Florida 12792
Issued Date
Sep 24, 2004
Effective Date
Apr 5, 2012
Category
Health Care
Type
Vehicle Permit (ALS)
Address
Address
Florida
LicenseFiles verified this license of Jun 1, 2017 at the Health Care Practitioner Data Portal.

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