License holder summary

Amanda S. Stack is a Radiology Provisional Permit licensed to practice in Indiana. The address on file for Amanda S. Stack is Fort Wayne IN 46818. This licensed professional license is not current. The license was granted 07/29/2013 and expired on 01/29/2014.

Indiana

Professional Licensing Agency

Amanda S. Stack
Radiology Provisional Permit
License number
XP504864
Date granted
07/29/2013
Date expires
01/29/2014
Class
Radiology Provisional Permit
Status
Superceded
Address
Fort Wayne IN 46818
indianalicensing.org
ID 8490844
LAST UPDATED 2024-04-06 04:51:27 UTC

This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.

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