The holder whose full name is Cosby IV, Ernest,come from Indianapolis IN,hold the Radiology Student Permit - Radiography license(NO.XS004257) which status is Superceded.
| Name | Cosby IV, Ernest |
|---|---|
| License Number | XS004257 |
| License Type | Radiology Student Permit - Radiography |
| License Status | Superceded |
| City | Indianapolis |
| State | IN |