Indiana
Professional Licensing Agency
Samuel C. Wyse
Radiology Provisional Permit
License number
XP503623
Date granted
09/19/2011
Date expires
03/19/2012
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Goshen IN 46528
indianalicensing.org
ID 8491402
LAST UPDATED 2024-04-28 20:47:42 UTC
LAST UPDATED 2024-04-28 20:47:42 UTC
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