Indiana
Professional Licensing Agency
Tammy R. Grossman
Radiology Provisional Permit
License number
XP505677
Date granted
07/16/2014
Date expires
01/16/2015
Class
Radiology Provisional Permit
Status
Active
Address
New Haven IN 46774
indianalicensing.org
ID 29207300
LAST UPDATED 2026-05-22 03:29:45 UTC
LAST UPDATED 2026-05-22 03:29:45 UTC
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