The holder whose full name is Washburn, Gale L.,come from Plainfield IN,hold the Radiology Provisional Permit - Limited Medical Radiology license(NO.XP500355) which status is Superceded.
| Name | Washburn, Gale L. |
|---|---|
| License Number | XP500355 |
| License Type | Radiology Provisional Permit - Limited Medical Radiology |
| License Status | Superceded |
| City | Plainfield |
| State | IN |