Indiana
Professional Licensing Agency
Elizabeth H. Forbes
Radiology Provisional Permit
License number
XP504707
Date granted
04/25/2013
Date expires
10/25/2013
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
New Haven IN 46774
indianalicensing.org
ID 8488822
LAST UPDATED 2026-06-13 11:01:10 UTC
LAST UPDATED 2026-06-13 11:01:10 UTC
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