Idaho
Division of Occupational and Professional Licenses
REBECCA ANN GOVERNALE
Board Of Medicine
License number
PAT-1316
Date granted
10/01/2015
Date expires
08/04/2017
Class
Board Of Medicine
Status
Licensed
Address
1824 E CENTER ST POCATELLO ID 83201
idaholicensing.com
ID 48351627
LAST UPDATED 2024-03-19 11:14:47 UTC
LAST UPDATED 2024-03-19 11:14:47 UTC
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