Indiana
Professional Licensing Agency
Brooke M. Moffitt
Radiology Provisional Permit
License number
XP502470
Date granted
03/29/2010
Date expires
09/29/2010
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Plainfield IN 46168-8210
indianalicensing.org
ID 8494750
LAST UPDATED 2024-04-13 03:07:29 UTC
LAST UPDATED 2024-04-13 03:07:29 UTC
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