The holder whose full name is Black, Elizabeth G.,come from Indianapolis IN,hold the Radiology Provisional Permit - Cardiac Catheterization license(NO.XP501001) which status is Superceded.
| Name | Black, Elizabeth G. |
|---|---|
| License Number | XP501001 |
| License Type | Radiology Provisional Permit - Cardiac Catheterization |
| License Status | Superceded |
| City | Indianapolis |
| State | IN |