The holder whose full name is Ballard, Ada G.,come from Mount Carmel IL,hold the Radiology Student Permit - Radiography license(NO.XS004733) which status is Superceded.
| Name | Ballard, Ada G. |
|---|---|
| License Number | XS004733 |
| License Type | Radiology Student Permit - Radiography |
| License Status | Superceded |
| City | Mount Carmel |
| State | IL |