Indiana
Professional Licensing Agency
Shelby Forsyth
Radiology Provisional Permit
License number
XP505320
Date granted
02/12/2014
Date expires
08/12/2014
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Indianapolis IN 46217
indianalicensing.org
ID 29206840
LAST UPDATED 2026-04-15 08:42:22 UTC
LAST UPDATED 2026-04-15 08:42:22 UTC
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