Indiana
Professional Licensing Agency
Lacey J. Martin
Radiology Provisional Permit
License number
XP502815
Date granted
09/02/2010
Date expires
03/02/2011
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Indianapolis IN 46237-2216
indianalicensing.org
ID 8492461
LAST UPDATED 2024-05-09 01:24:49 UTC
LAST UPDATED 2024-05-09 01:24:49 UTC
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