Indiana
Professional Licensing Agency
Holly Denise Brine
Medical Residency Permit
License number
11016001A
Date granted
05/24/2011
Date expires
06/30/2014
Class
Medical Residency Permit
Status
Expired
Address
Fishers IN 46038
indianalicensing.org
ID 5977458
LAST UPDATED 2026-05-07 09:29:40 UTC
LAST UPDATED 2026-05-07 09:29:40 UTC
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