License holder summary

ARIEL SHANTAY AVIS TAYSOM is a Board Of Medicine licensed to practice in Idaho. The address on file for ARIEL SHANTAY AVIS TAYSOM is 3863 HAWTHORNE RD POCATELLO ID 83201. This licensed professional license is current. The license was granted 09/01/2016 and expired on 08/03/2018.

Idaho

Division of Occupational and Professional Licenses

ARIEL SHANTAY AVIS TAYSOM
Board Of Medicine
License number
PAT-1455
Date granted
09/01/2016
Date expires
08/03/2018
Class
Board Of Medicine
Status
Licensed
Address
3863 HAWTHORNE RD POCATELLO ID 83201
idaholicensing.com
ID 48361311
LAST UPDATED 2024-05-01 03:24:15 UTC

This website is unaffiliated with the Division of Occupational and Professional Licenses. Please verify all information directly with the relevant official government authority.

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