Indiana
Professional Licensing Agency
Traci Lippold
Temporary Physician Assistant Permit
License number
99059251A
Date granted
10/01/2013
Date expires
07/01/2014
Class
Temporary Physician Assistant Permit
Status
Superceded
Address
Columbus IN 47201
indianalicensing.org
ID 8392636
LAST UPDATED 2024-04-23 19:42:53 UTC
LAST UPDATED 2024-04-23 19:42:53 UTC
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