Indiana
Professional Licensing Agency
Michele Consuelo Mendoza
Radiology Provisional Permit
License number
XP500661
Date granted
12/15/2006
Date expires
12/31/2007
Class
Radiology Provisional Permit
Status
Superceded
Address
Indianapolis IN 46254
indianalicensing.org
ID 8492531
LAST UPDATED 2024-02-17 12:37:55 UTC
LAST UPDATED 2024-02-17 12:37:55 UTC
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