Idaho
Division of Occupational and Professional Licenses
MARY ELAINE WAGGONER
Board Of Medicine
License number
LRT-1987
Date granted
09/08/2016
Date expires
06/30/2017
Class
Board Of Medicine
Status
Licensed
Address
14288 BLUE RIDGE ST CALDWELL ID 83607
idaholicensing.com
ID 48334515
LAST UPDATED 2024-03-23 19:48:35 UTC
LAST UPDATED 2024-03-23 19:48:35 UTC
This website is unaffiliated with the Division of Occupational and Professional Licenses. Please verify all information directly with the relevant official government authority.