Idaho
Division of Occupational and Professional Licenses
TYLER JAY SHAW
Board Of Medicine
License number
PAT-1200
Date granted
09/25/2014
Date expires
08/05/2016
Class
Board Of Medicine
Status
Expired
Address
125 CHASE ST POCATELLO ID 83201
idaholicensing.com
ID 48339562
LAST UPDATED 2024-04-10 20:52:02 UTC
LAST UPDATED 2024-04-10 20:52:02 UTC
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