Indiana
Professional Licensing Agency
Fallon M. Goodman
Radiology Provisional Permit
License number
XP501494
Date granted
11/07/2008
Date expires
05/07/2009
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Lowell IN 46356-1474
indianalicensing.org
ID 8493403
LAST UPDATED 2024-03-06 09:30:36 UTC
LAST UPDATED 2024-03-06 09:30:36 UTC
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