Indiana
Professional Licensing Agency
Crystal N. Puckett
Radiology Provisional Permit
License number
XP501402
Date granted
09/25/2008
Date expires
03/25/2009
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Bristol IN 46507-8846
indianalicensing.org
ID 8489232
LAST UPDATED 2024-03-31 07:59:08 UTC
LAST UPDATED 2024-03-31 07:59:08 UTC
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