Idaho
Division of Occupational and Professional Licenses
DR. MATTHEW ROGER BLACK
Board Of Medicine
License number
O-0477
Date granted
04/23/2008
Class
Board Of Medicine
Status
Revoked
Address
450 E Main Rexburg ID 83440
idaholicensing.com
ID 48329243
LAST UPDATED 2024-04-23 22:08:11 UTC
LAST UPDATED 2024-04-23 22:08:11 UTC
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