Indiana
Professional Licensing Agency
Stephanie L. Waidlich
Radiology Provisional Permit
License number
XP500590
Date granted
09/02/2005
Date expires
12/31/2007
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Greenwood IN 461421562
indianalicensing.org
ID 8491623
LAST UPDATED 2026-05-15 10:41:01 UTC
LAST UPDATED 2026-05-15 10:41:01 UTC
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