Indiana
Professional Licensing Agency
JerriLynn K. Haywood
Radiology Provisional Permit
License number
XP503586
Date granted
09/09/2011
Date expires
03/09/2012
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Portage IN 46368-1729
indianalicensing.org
ID 8494833
LAST UPDATED 2026-06-12 21:35:03 UTC
LAST UPDATED 2026-06-12 21:35:03 UTC
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