The holder whose full name is Ford, Amanda J.,come from Valparaiso IN,hold the Radiology Provisional Permit - Podiatric Radiography license(NO.XP501957) which status is Superceded.
| Name | Ford, Amanda J. |
|---|---|
| License Number | XP501957 |
| License Type | Radiology Provisional Permit - Podiatric Radiography |
| License Status | Superceded |
| City | Valparaiso |
| State | IN |