License holder summary

Stacey J. Dishman is a Radiology Provisional Permit licensed to practice in Indiana. The address on file for Stacey J. Dishman is Lynn IN 47355-9089. This licensed professional license is not current. The license was granted 02/25/2009 and expired on 08/25/2009.

Indiana

Professional Licensing Agency

Stacey J. Dishman
Radiology Provisional Permit
License number
XP501667
Date granted
02/25/2009
Date expires
08/25/2009
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Lynn IN 47355-9089
indianalicensing.org
ID 8493439
LAST UPDATED 2024-02-18 19:07:12 UTC

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