License holder summary

Jordan M Wallace is a Radiology Student Permit licensed to practice in Indiana. The address on file for Jordan M Wallace is Westfield IN 46074. This licensed professional license is current. The license was granted 07/23/2014 and expired on 11/30/2016.

Indiana

Professional Licensing Agency

Jordan M Wallace
Radiology Student Permit
License number
XS007449
Date granted
07/23/2014
Date expires
11/30/2016
Class
Radiology Student Permit
Status
Active
Address
Westfield IN 46074
indianalicensing.org
ID 29209727
LAST UPDATED 2024-03-21 13:26:57 UTC

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