The holder whose full name is Ellis, Jason L.,come from Valparaiso IN,hold the Radiology Student Permit - Radiography license(NO.XS005545) which status is Superceded.
| Name | Ellis, Jason L. |
|---|---|
| License Number | XS005545 |
| License Type | Radiology Student Permit - Radiography |
| License Status | Superceded |
| City | Valparaiso |
| State | IN |