Indiana
Professional Licensing Agency
Tara S. Holem
Radiology Provisional Permit
License number
XP501839
Date granted
06/11/2009
Date expires
12/11/2009
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Oaktown IN 47561-0036
indianalicensing.org
ID 8494550
LAST UPDATED 2026-04-11 19:28:24 UTC
LAST UPDATED 2026-04-11 19:28:24 UTC
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