License Information

The holder whose full name is Blackston, Allysia M.,come from New Carlisle IN,hold the Radiology Provisional Permit - Podiatric Radiography license(NO.XP500951) which status is Superceded.

NameBlackston, Allysia M.
License NumberXP500951
License TypeRadiology Provisional Permit - Podiatric Radiography
License StatusSuperceded
CityNew Carlisle
StateIN

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