License holder summary

Michelle Fortenberry is a Radiology Provisional Permit licensed to practice in Indiana. The address on file for Michelle Fortenberry is Gary IN 46408-3052. This licensed professional license is not current. The license was granted 12/05/2011 and expired on 06/05/2012.

Indiana

Professional Licensing Agency

Michelle Fortenberry
Radiology Provisional Permit
License number
XP503769
Date granted
12/05/2011
Date expires
06/05/2012
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Gary IN 46408-3052
indianalicensing.org
ID 8491253
LAST UPDATED 2024-05-11 06:37:40 UTC

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