Indiana
Professional Licensing Agency
Kathleen M. Modafari
Radiology Provisional Permit
License number
XP500064
Date granted
06/15/2007
Date expires
12/31/2007
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Princeton IN 476702402
indianalicensing.org
ID 8494904
LAST UPDATED 2026-04-19 04:24:35 UTC
LAST UPDATED 2026-04-19 04:24:35 UTC
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