Indiana
Professional Licensing Agency
Sarah I. Blaylock
Radiology Provisional Permit
License number
XP503585
Date granted
09/09/2011
Date expires
03/09/2012
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Crown Point IN 46307
indianalicensing.org
ID 8490066
LAST UPDATED 2026-04-29 15:17:19 UTC
LAST UPDATED 2026-04-29 15:17:19 UTC
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