License holder summary

Tibisay Pena is a Radiology Student Permit licensed to practice in Indiana. The address on file for Tibisay Pena is South Bend IN 46614. This licensed professional license is not current. The license was granted 07/29/2009 and expired on 11/30/2011.

Indiana

Professional Licensing Agency

Tibisay Pena
Radiology Student Permit
License number
XS003070
Date granted
07/29/2009
Date expires
11/30/2011
Class
Radiology Student Permit
Status
Expired Non-Renewable
Address
South Bend IN 46614
indianalicensing.org
ID 8503334
LAST UPDATED 2024-03-25 22:23:52 UTC

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