Indiana
Professional Licensing Agency
Leesa E. Jacobs
Radiology Provisional Permit
License number
XP504111
Date granted
06/06/2012
Date expires
12/06/2012
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Hartford City IN 47348
indianalicensing.org
ID 8491893
LAST UPDATED 2024-02-15 15:27:21 UTC
LAST UPDATED 2024-02-15 15:27:21 UTC
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