Indiana
Professional Licensing Agency
Shanice J. Kipp
Radiology Provisional Permit
License number
XP502982
Date granted
11/10/2010
Date expires
05/10/2011
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
South Bend IN 46615-1229
indianalicensing.org
ID 8495488
LAST UPDATED 2024-03-26 22:59:41 UTC
LAST UPDATED 2024-03-26 22:59:41 UTC
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