Indiana
Professional Licensing Agency
Johanna R. Vasquez
Radiology Provisional Permit
License number
XP504071
Date granted
05/15/2012
Date expires
11/15/2012
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Goshen IN 46526
indianalicensing.org
ID 8491371
LAST UPDATED 2024-03-31 10:29:49 UTC
LAST UPDATED 2024-03-31 10:29:49 UTC
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