Indiana
Professional Licensing Agency
Shannon D. Farmer
Radiology Provisional Permit
License number
XP500992
Date granted
02/19/2008
Date expires
12/16/2011
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Brownstown IN 47220-9733
indianalicensing.org
ID 8489308
LAST UPDATED 2024-05-10 06:04:24 UTC
LAST UPDATED 2024-05-10 06:04:24 UTC
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