Indiana
Professional Licensing Agency
Mary E. Wallace
Radiology Provisional Permit
License number
XP501754
Date granted
04/22/2009
Date expires
10/22/2009
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Swayzee IN 46986-9757
indianalicensing.org
ID 8495610
LAST UPDATED 2024-02-09 05:42:17 UTC
LAST UPDATED 2024-02-09 05:42:17 UTC
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