Idaho
Division of Occupational and Professional Licenses
BRUCE WAYNE PETERSON
Board Of Medicine
License number
RTS-698
Date granted
10/30/2014
Date expires
09/01/2016
Class
Board Of Medicine
Status
Expired
Address
384 W 300 N BLACKFOOT ID 83221
idaholicensing.com
ID 48348814
LAST UPDATED 2024-04-28 21:03:17 UTC
LAST UPDATED 2024-04-28 21:03:17 UTC
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