The holder whose full name is Shackelford, Krista E.,come from Indianapolis IN,hold the Medical Residency Permit license(NO.11010917A) which status is Superceded.
| Name | Shackelford, Krista E. |
|---|---|
| License Number | 11010917A |
| License Type | Medical Residency Permit |
| License Status | Superceded |
| City | Indianapolis |
| State | IN |