The holder whose full name is Smith, Charles D.,come from Louisville KY,hold the Radiology Provisional Permit - Chest Radiography license(NO.XP502697) which status is Superceded.
| Name | Smith, Charles D. |
|---|---|
| License Number | XP502697 |
| License Type | Radiology Provisional Permit - Chest Radiography |
| License Status | Superceded |
| City | Louisville |
| State | KY |