Indiana
Professional Licensing Agency
Kathryn L. Wallace
Radiology Provisional Permit
License number
XP503730
Date granted
11/09/2011
Date expires
05/09/2012
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Muncie IN 47304-4422
indianalicensing.org
ID 8494049
LAST UPDATED 2024-05-14 17:08:18 UTC
LAST UPDATED 2024-05-14 17:08:18 UTC
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