License holder summary

Shelly D. Jackson is a Radiology Provisional Permit licensed to practice in Indiana. The address on file for Shelly D. Jackson is Salem IN 47167-8792. This licensed professional license is not current. The license was granted 06/25/2009 and expired on 12/25/2009.

Indiana

Professional Licensing Agency

Shelly D. Jackson
Radiology Provisional Permit
License number
XP501860
Date granted
06/25/2009
Date expires
12/25/2009
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Salem IN 47167-8792
indianalicensing.org
ID 8495147
LAST UPDATED 2024-04-12 14:48:19 UTC

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