Idaho
Division of Occupational and Professional Licenses
KELLY LANETTE SPARKS
Board Of Medicine
License number
LRT-1064
Date granted
07/01/2004
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
1365 SILVER CREEK WAY TWIN FALLS ID 83301
idaholicensing.com
ID 48356756
LAST UPDATED 2024-02-14 23:19:38 UTC
LAST UPDATED 2024-02-14 23:19:38 UTC
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