Indiana
Professional Licensing Agency
Ivy C. Crockett
Dental Radiographer
License number
XT020194
Date granted
01/03/2012
Date expires
01/03/2016
Class
Dental Radiographer
Status
Active
Address
Elkhart IN 46514
indianalicensing.org
ID 8461655
LAST UPDATED 2026-05-06 14:41:03 UTC
LAST UPDATED 2026-05-06 14:41:03 UTC
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