Idaho
Division of Occupational and Professional Licenses
DAVID WANLESS SOUTHWICK
Board Of Medicine
License number
LRT-1108
Date granted
06/24/2005
Date expires
06/30/2018
Class
Board Of Medicine
Status
Renewed
Address
463 SOUTH SILVER BOW AVE EAGLE ID 83616
idaholicensing.com
ID 48353779
LAST UPDATED 2024-02-26 22:31:57 UTC
LAST UPDATED 2024-02-26 22:31:57 UTC
This website is unaffiliated with the Division of Occupational and Professional Licenses. Please verify all information directly with the relevant official government authority.