License holder summary

Lisa M. Boucher is a Radiology Provisional Permit licensed to practice in Indiana. The address on file for Lisa M. Boucher is Memphis IN 47143. This licensed professional license is not current. The license was granted 05/01/2014 and expired on 11/01/2014.

Indiana

Professional Licensing Agency

Lisa M. Boucher
Radiology Provisional Permit
License number
XP505524
Date granted
05/01/2014
Date expires
11/01/2014
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Memphis IN 47143
indianalicensing.org
ID 29207097
LAST UPDATED 2024-05-03 22:49:12 UTC

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