License holder summary

Kathleen M. Modafari is a Radiology Provisional Permit licensed to practice in Indiana. The address on file for Kathleen M. Modafari is Princeton IN 476702402. This licensed professional license is not current. The license was granted 06/15/2007 and expired on 12/31/2007.

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 2024-04-07 18:38:53 UTC

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