Idaho
Division of Occupational and Professional Licenses
Dr. GUILLERMO MODAD
Board Of Medicine
License number
M-12525
Date granted
06/23/2014
Date expires
06/30/2018
Class
Board Of Medicine
Status
Renewed
Address
313 S MONROE ST MOSCOW ID 83843
idaholicensing.com
ID 48330011
LAST UPDATED 2024-04-16 23:48:01 UTC
LAST UPDATED 2024-04-16 23:48:01 UTC
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