Indiana
Professional Licensing Agency
ReBecca M. Samp
Radiology Provisional Permit
License number
XP505209
Date granted
01/21/2014
Date expires
07/21/2014
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Mishawaka IN 46545
indianalicensing.org
ID 29207161
LAST UPDATED 2024-02-05 06:24:58 UTC
LAST UPDATED 2024-02-05 06:24:58 UTC
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