Indiana
Professional Licensing Agency
Denise E. Follmar
Radiology Provisional Permit
License number
XP503439
Date granted
06/13/2011
Date expires
12/13/2011
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Dyer IN 46311-2897
indianalicensing.org
ID 8490239
LAST UPDATED 2026-04-15 00:40:43 UTC
LAST UPDATED 2026-04-15 00:40:43 UTC
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