Indiana
Professional Licensing Agency
Jessica J. Bouse
Radiology Provisional Permit
License number
XP505392
Date granted
03/07/2014
Date expires
09/07/2014
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Poneto IN 46781
indianalicensing.org
ID 29207445
LAST UPDATED 2026-03-27 15:25:12 UTC
LAST UPDATED 2026-03-27 15:25:12 UTC
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