Indiana
Professional Licensing Agency
Beverly J. Henzman
Radiology Provisional Permit
License number
XP503109
Date granted
01/21/2011
Date expires
07/21/2011
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Newburgh IN 47630-7961
indianalicensing.org
ID 8494339
LAST UPDATED 2024-03-07 12:27:24 UTC
LAST UPDATED 2024-03-07 12:27:24 UTC
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