Indiana
Professional Licensing Agency
Kimberly M. Ivy
Radiology Provisional Permit
License number
XP502833
Date granted
09/13/2010
Date expires
03/13/2011
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Indianapolis IN 46250-1390
indianalicensing.org
ID 8492435
LAST UPDATED 2026-05-04 00:24:55 UTC
LAST UPDATED 2026-05-04 00:24:55 UTC
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