Indiana
Professional Licensing Agency
Madelyn C. Holm
Radiology Provisional Permit
License number
XP505060
Date granted
10/18/2013
Date expires
04/18/2014
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Indianapolis IN 46221
indianalicensing.org
ID 12407218
LAST UPDATED 2024-01-02 22:29:53 UTC
LAST UPDATED 2024-01-02 22:29:53 UTC
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