BOARD OF PHYSICIANS Allied Health Division P.O Box / / /
Position
physician / Signature Medical Director / medical radiation technologist / CT Technologist / NUCLEAR MEDICINE TECHNOLOGIST / *qualified CT technologist / qualified CT technologist / CT technologist and the Medical Director of the Imaging Department / Signature/License# CT Technologist / Medical Director / /
Product
CT Intravenous Contrast Injections / /
ProvinceOrState
Maryland / Connecticut / working on a CT. / operating a CT / /