Indiana
Professional Licensing Agency
Shawn Maynard
Radiology Provisional Permit
License number
XP505205
Date granted
01/17/2014
Date expires
07/17/2014
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Fort Wayne IN 46835
indianalicensing.org
ID 29206453
LAST UPDATED 2024-03-12 22:04:44 UTC
LAST UPDATED 2024-03-12 22:04:44 UTC
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