License holder summary

Bethanie D. Bridegroom is a Radiology Provisional Permit licensed to practice in Indiana. The address on file for Bethanie D. Bridegroom is North Judson IN 463668761. This licensed professional license is not current. The license was granted 10/06/2006 and expired on 12/31/2007.

Indiana

Professional Licensing Agency

Bethanie D. Bridegroom
Radiology Provisional Permit
License number
XP500360
Date granted
10/06/2006
Date expires
12/31/2007
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
North Judson IN 463668761
indianalicensing.org
ID 8494508
LAST UPDATED 2024-03-20 05:24:59 UTC

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