Brooke E. Stacy
Radiology Provisional Permit
Indiana XP503807 Superceded
This Indiana license was held by Brooke E. Stacy. The license is no longer active. It was granted on 01/04/2012 and expired on 07/04/2012
LICENSE DETAILS
- License Number: XP503807
- Category: Radiology Provisional Permit
- Status: Superceded
- Date Granted: 01/04/2012 (over 12 years ago)
- Expiry Date: 07/04/2012 (almost 12 years ago)
LOCATIONS
A Address
Fort Wayne IN 46835