Indiana
Professional Licensing Agency
Gily N. Martinez
Radiology Provisional Permit
License number
XP500548
Date granted
03/10/2005
Date expires
12/31/2007
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Fort Wayne IN 468071748
indianalicensing.org
ID 8490919
LAST UPDATED 2024-04-16 09:26:49 UTC
LAST UPDATED 2024-04-16 09:26:49 UTC
This website is unaffiliated with the Professional Licensing Agency. Please verify all information directly with the relevant official government authority.