Indiana
Professional Licensing Agency
Kathy M. Niccum
Radiology Provisional Permit
License number
XP500977
Date granted
02/11/2008
Date expires
08/11/2008
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Scottsburg IN 47170-8051
indianalicensing.org
ID 8495217
LAST UPDATED 2024-03-27 07:41:45 UTC
LAST UPDATED 2024-03-27 07:41:45 UTC
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