Indiana
Professional Licensing Agency
Shelby N. Clark
Radiology Provisional Permit
License number
XP504088
Date granted
05/29/2012
Date expires
11/29/2012
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
North Vernon IN 47265-7230
indianalicensing.org
ID 8494539
LAST UPDATED 2024-03-03 17:48:22 UTC
LAST UPDATED 2024-03-03 17:48:22 UTC
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