Indiana
Professional Licensing Agency
Kimberly A. Ivezich
Radiology Provisional Permit
License number
XP502838
Date granted
09/13/2010
Date expires
03/13/2011
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Crown Point IN 46307-4807
indianalicensing.org
ID 8490012
LAST UPDATED 2024-02-20 23:25:02 UTC
LAST UPDATED 2024-02-20 23:25:02 UTC
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