The holder whose full name is Bruick, Denice A.,come from Fort Wayne IN,hold the Radiology Provisional Permit - Cardiac Catheterization license(NO.XP503421) which status is Superceded.
| Name | Bruick, Denice A. |
|---|---|
| License Number | XP503421 |
| License Type | Radiology Provisional Permit - Cardiac Catheterization |
| License Status | Superceded |
| City | Fort Wayne |
| State | IN |