Indiana
Professional Licensing Agency
Brandie L. Prungle
Radiology Provisional Permit
License number
XP505885
Date granted
10/02/2014
Date expires
04/02/2015
Class
Radiology Provisional Permit
Status
Active
Address
Coatesville IN 46121
indianalicensing.org
ID 29206127
LAST UPDATED 2026-04-01 01:10:55 UTC
LAST UPDATED 2026-04-01 01:10:55 UTC
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