License holder summary

Jackie M. Shaw is a Radiology Provisional Permit licensed to practice in Indiana. The address on file for Jackie M. Shaw is Richmond IN 47374. This licensed professional license is not current. The license was granted 09/19/2013 and expired on 03/19/2014.

Indiana

Professional Licensing Agency

Jackie M. Shaw
Radiology Provisional Permit
License number
XP504975
Date granted
09/19/2013
Date expires
03/19/2014
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Richmond IN 47374
indianalicensing.org
ID 8494972
LAST UPDATED 2024-03-23 16:11:54 UTC

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