The holder whose full name is Wallace, Jennifer N.,come from Indianapolis IN,hold the Radiology Provisional Permit - Podiatric Radiography license(NO.XP500264) which status is Expired Non-Renewable.
| Name | Wallace, Jennifer N. |
|---|---|
| License Number | XP500264 |
| License Type | Radiology Provisional Permit - Podiatric Radiography |
| License Status | Expired Non-Renewable |
| City | Indianapolis |
| State | IN |