Indiana
Professional Licensing Agency
Michal A. Jackson
Radiology Provisional Permit
License number
XP501266
Date granted
07/14/2008
Date expires
01/14/2009
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Pekin IN 47165-8633
indianalicensing.org
ID 8494693
LAST UPDATED 2024-04-09 23:44:36 UTC
LAST UPDATED 2024-04-09 23:44:36 UTC
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