Indiana
Professional Licensing Agency
Stephenie L. Lane
Radiology Provisional Permit
License number
XP505089
Date granted
11/07/2013
Date expires
05/07/2014
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
South Bend IN 46628
indianalicensing.org
ID 12409104
LAST UPDATED 2024-03-16 12:59:05 UTC
LAST UPDATED 2024-03-16 12:59:05 UTC
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