Indiana
Professional Licensing Agency
Tara B. Boggs
Radiology Provisional Permit
License number
XP505613
Date granted
06/13/2014
Date expires
12/13/2014
Class
Radiology Provisional Permit
Status
Active
Address
Brookville IN 47012
indianalicensing.org
ID 29206029
LAST UPDATED 2026-04-07 21:39:52 UTC
LAST UPDATED 2026-04-07 21:39:52 UTC
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