Indiana
Professional Licensing Agency
In S. Em
Radiology Provisional Permit
License number
XP504834
Date granted
07/08/2013
Date expires
01/08/2014
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Spencer IN 47460
indianalicensing.org
ID 8495524
LAST UPDATED 2026-04-30 10:46:39 UTC
LAST UPDATED 2026-04-30 10:46:39 UTC
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