Indiana
Professional Licensing Agency
Collin E. Johnson
Radiology Provisional Permit
License number
XP505056
Date granted
10/18/2013
Date expires
04/18/2014
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Fairland IN 46126
indianalicensing.org
ID 12406182
LAST UPDATED 2026-04-19 23:24:37 UTC
LAST UPDATED 2026-04-19 23:24:37 UTC
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