Idaho
Division of Occupational and Professional Licenses
LESLIE IRENE BURNSIDE
Board Of Medicine
License number
PA-518
Date granted
10/19/2004
Date expires
06/30/2017
Class
Board Of Medicine
Status
Renewed
Address
147 W CHUBBUCK RD Chubbuck ID 83202
idaholicensing.com
ID 48342031
LAST UPDATED 2024-04-11 08:09:46 UTC
LAST UPDATED 2024-04-11 08:09:46 UTC
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