Indiana
Professional Licensing Agency
Rebecca A Fuentes
Radiology Provisional Permit
License number
XP505093
Date granted
11/13/2013
Date expires
05/13/2014
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Milford IN 46542
indianalicensing.org
ID 29207142
LAST UPDATED 2026-05-10 20:18:53 UTC
LAST UPDATED 2026-05-10 20:18:53 UTC
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