The holder whose full name is Jasper, Marquita M.,come from Lawrenceburg IN,hold the Radiology Provisional Permit - Limited Medical Radiology license(NO.XP500577) which status is Expired Non-Renewable.
| Name | Jasper, Marquita M. |
|---|---|
| License Number | XP500577 |
| License Type | Radiology Provisional Permit - Limited Medical Radiology |
| License Status | Expired Non-Renewable |
| City | Lawrenceburg |
| State | IN |