The holder whose full name is Longsworth, Jean P.,come from Fort Wayne IN,hold the Radiology Student Permit - Radiography license(NO.XS002294) which status is Superceded.
| Name | Longsworth, Jean P. |
|---|---|
| License Number | XS002294 |
| License Type | Radiology Student Permit - Radiography |
| License Status | Superceded |
| City | Fort Wayne |
| State | IN |