The holder whose full name is Ford, Ellen L.,come from Indianapolis IN,hold the Radiology Provisional Permit - Podiatric Radiography license(NO.XP503453) which status is Superceded.
| Name | Ford, Ellen L. |
|---|---|
| License Number | XP503453 |
| License Type | Radiology Provisional Permit - Podiatric Radiography |
| License Status | Superceded |
| City | Indianapolis |
| State | IN |