License holder summary

Jamie Lynn Wallace is a Radiology Provisional Permit licensed to practice in Indiana. The address on file for Jamie Lynn Wallace is Sheridan IN 46069. This licensed professional license is not current. The license was granted 04/23/2013 and expired on 10/23/2013.

Indiana

Professional Licensing Agency

Jamie Lynn Wallace
Radiology Provisional Permit
License number
XP504692
Date granted
04/23/2013
Date expires
10/23/2013
Class
Radiology Provisional Permit
Status
Superceded
Address
Sheridan IN 46069
indianalicensing.org
ID 8495335
LAST UPDATED 2024-01-30 16:18:17 UTC

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