Indiana
Professional Licensing Agency
Jennifer L. Black
Radiology Student Permit
License number
XS006471
Date granted
06/04/2013
Date expires
12/31/2015
Class
Radiology Student Permit
Status
Active
Address
Seymour IN 47274
indianalicensing.org
ID 8503135
LAST UPDATED 2026-03-30 00:37:03 UTC
LAST UPDATED 2026-03-30 00:37:03 UTC
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