Indiana
Professional Licensing Agency
Amanda L. Polston
Radiology Provisional Permit
License number
XP503263
Date granted
03/15/2011
Date expires
09/15/2011
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Terre Haute IN 47804-1242
indianalicensing.org
ID 8495646
LAST UPDATED 2024-04-08 04:05:29 UTC
LAST UPDATED 2024-04-08 04:05:29 UTC
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