Idaho
Division of Occupational and Professional Licenses
ADDIE SUSANNAH BARNES
Board Of Medicine
License number
PA-1418
Date granted
09/27/2016
Date expires
06/30/2018
Class
Board Of Medicine
Status
Licensed
Address
4006 MORNING CREST WAY KINGMAN AZ 86409
idaholicensing.com
ID 48337328
LAST UPDATED 2024-03-23 21:10:15 UTC
LAST UPDATED 2024-03-23 21:10:15 UTC
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