The holder whose full name is Fuller, Alex E.,come from Fort Wayne IN,hold the Radiology Student Permit - Radiography license(NO.XS004414) which status is Superceded.
| Name | Fuller, Alex E. |
|---|---|
| License Number | XS004414 |
| License Type | Radiology Student Permit - Radiography |
| License Status | Superceded |
| City | Fort Wayne |
| State | IN |