Indiana
Professional Licensing Agency
Kadidja Goni Mallcum
Radiology Provisional Permit
License number
XP506019
Date granted
11/12/2014
Date expires
05/12/2015
Class
Radiology Provisional Permit
Status
Active
Address
Fort Wayne IN 46825
indianalicensing.org
ID 29206431
LAST UPDATED 2024-04-22 22:01:29 UTC
LAST UPDATED 2024-04-22 22:01:29 UTC
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