License holder summary

Kisha M. Brooks is a Radiology Provisional Permit licensed to practice in Indiana. The address on file for Kisha M. Brooks is Fort Wayne, IN 46807. This licensed professional license is not current. The license was granted 04/04/2014 and expired on 10/04/2014.

Indiana

Professional Licensing Agency

Kisha M. Brooks
Radiology Provisional Permit
License number
XP505461
Date granted
04/04/2014
Date expires
10/04/2014
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Fort Wayne, IN 46807
indianalicensing.org
ID 29206433
LAST UPDATED 2024-01-12 12:55:38 UTC

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