Indiana
Professional Licensing Agency
Taylor C. Lacefield
Radiology Provisional Permit
License number
XP503342
Date granted
04/19/2011
Date expires
10/19/2011
Class
Radiology Provisional Permit
Status
Expired Non-Renewable
Address
Gary IN 46406-1658
indianalicensing.org
ID 8491279
LAST UPDATED 2026-06-19 13:11:29 UTC
LAST UPDATED 2026-06-19 13:11:29 UTC
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